STIs

Question 1

What are the risk factors for acquiring an STI?

Answer 1

• # of sexual partners
• MSM
• illicit drug use
• sexually active and <25 yrs old

Question 2

What are the appropriate diagnostic tests for STIs?

Answer 2

chlamydia; NAAT
gonorrhea; NAAT, gram-stain, culture if treatment failure
syphilis; treponemal AND non-treponemal
neurosyphilis; CSF cell counts
trichomoniasis; wet mount of discharge
BV; gram-stain

Question 3

First line treatment for chlamydia

Answer 3

doxycycline 100 mg PO BID x 7 days

Question 4

Alternative treatment for chlamydia

Answer 4

azithromycin 1 g PO once
levofloxacin 500 mg PO daily x 7 days

Question 5

First line treatment for gonorrhea

Answer 5

uncomplicated;
500 mg ceftriaxone IM once
(if >150 kg, 1000mg)

chlamydial co-infection;
add 100 mg doxycycline BID x 7 days

Question 6

First line treatment for syphilis

Answer 6

Infection acquired within past year;
benzathine penicillin G 2.4 mu IM once

infection > 1 year;
“” 3 doses 1 week apart

Question 7

First line treatment for trichomoniasis

Answer 7

male; metronidazole 2g PO once
female; metronidazole 500 mg PO BID x 7 days

Question 8

First line treatment for bacterial vaginosis

Answer 8

metronidazole 500 mg PO BID x 7 days

Question 9

Alternative treatment for gonorrhea

Answer 9

cefixime 800 mg PO once

severe cephalosporin allergy;
gentamicin 240 mg IM once + azithromycin 2 g PO once

Question 10

Alternative treatment for syphilis

Answer 10

doxycycline 100 mg PO BID x 14 days
(if infected > 1 yr, 28 days)

Question 11

Alternative treatment for trichomoniasis

Answer 11

tinidazole 2 g PO once