- Keywords > Clinical Practice Guidelines (CPGs)
- Keywords > criteria of medicines selection
- Keywords > HIV infection and STIs
- Keywords > opportunistic infections and other HIV-related
- Keywords > reproductive tract infections
- Keywords > sexual and reproductive health
- Keywords > sexually transmitted infections (STIs)
- Keywords > treatment guidelines
- Keywords > treatment protocols
(2004; 88 pages)
Uncomplicated anogenital infection
• ciprofloxacin, 500mg orally, as a single dose
• azithromycin, 2g orally, as a single dose
• ceftriaxone, 125mg by intramuscular injection, as a single dose
• cefixime, 400mg orally, as a single dose
• spectinomycin, 2g by intramuscular injection, as a single dose.
• Ciprofloxacin is contraindicated in pregnancy, and is not recommended for use in children and adolescents.
• There is accumulating evidence that the cure rate of Azithromycin for gonococcal infections is best achieved by a 2-gram single dose regime. The 1-gram dose provides protracted sub-therapeutic levels which may precipitate the emergence of resistance.
There are variations in the anti-gonococcal activity of individual quinolones, and it is important to use only the most active.
Alternative regimens which may be useful in some countries, depending on the prevalence of resistant gonococci:
• kanamycin, 2g by intramuscular injection as a single dose
• trimethoprim (80mg)/sulfamethoxazole (400mg), 10 tablets orally, as a single dose daily for 3 days.
• Kanamycin and trimethoprim/sulfamethoxazole should only be used in areas where in vitro resistance rates are low and are monitored at regular intervals. In addition, second-line treatment with recommended drugs should be available.