Guidelines for the Management of Sexually Transmitted Infections. February 2004
(2004; 88 pages)
Table of Contents
View the documentPREFACE
Open this folder and view contents1. INTRODUCTION
Open this folder and view contents2. TREATMENT OF STI-ASSOCIATED SYNDROMES
Close this folder3. TREATMENT OF SPECIFIC INFECTIONS
Close this folder3.1. Gonococcal infections
View the documentUncomplicated anogenital infection
View the documentDisseminated infection
View the documentGonococcal ophthalmia
Open this folder and view contents3.2. Chlamydia trachomatis infections (other than lymphogranuloma venereum)
View the document3.3. Lymphogranuloma venereum
Open this folder and view contents3.4. Syphilis
View the document3.5. Chancroid
View the document3.6. Granuloma inguinale (Donovanosis)
Open this folder and view contents3.7. Genital herpes infections
Open this folder and view contents3.8. Venereal warts
View the document3.9. Trichomonas vaginalis infections
Open this folder and view contents3.10. Bacterial vaginosis
Open this folder and view contents3.11. Candidiasis
View the document3.12. Scabies
View the document3.13. Phthiriasis (pediculosis pubis)
Open this folder and view contents4. KEY CONSIDERATIONS UNDERLYING TREATMENTS
Open this folder and view contents5. PRACTICAL CONSIDERATIONS IN STI CASE MANAGEMENT
Open this folder and view contents6. CHILDREN6, ADOLESCENTS AND SEXUALLY TRANSMITTED INFECTIONS
View the documentANNEX. LIST OF PARTICIPANTS
 

Gonococcal ophthalmia

This is a serious condition that requires systemic therapy as well as local irrigation with saline or other appropriate solutions. Irrigation is particularly important when the recommended therapeutic regimens are not available. Careful hand washing by personnel caring for infected patients is essential.

A. ADULT GONOCOCCAL CONJUNCTIVITIS

Recommended regimen

• ceftriaxone, 125mg by intramuscular injection as a single dose

OR

• spectinomycin, 2g by intramuscular injection as a single dose

OR

• ciprofloxacin, 500mg orally, as a single dose.

This regimen is likely to be effective although there are no published data on its use in gonococcal ophthalmia.

Alternative regimen where the recommended agents are not available:

• kanamycin, 2g by intramuscular injection as a single dose.

Follow-up

Careful monitoring of clinical progress is important.

B. NEONATAL GONOCOCCAL CONJUNCTIVITIS

Recommended regimen

• ceftriaxone, 50 mg/kg by intramuscular injection as a single dose, to a maximum of 125mg.

Alternative regimen where ceftriaxone is not available

• kanamycin, 25 mg/kg by intramuscular injection as a single dose to a maximum of 75mg

OR

• spectinomycin, 25 mg/kg by intramuscular injection as a single dose to a maximum of 75mg.

Single-dose ceftriaxone and kanamycin are of proven efficacy. The addition of tetracycline eye ointment to these regimens is of no documented benefit.

Follow-up

Patients should be reviewed after 48 hours.

Prevention of ophthalmia neonatorum

Using timely eye prophylaxis should prevent gonococcal ophthalmia neonatorum. The infant's eyes should be carefully cleaned immediately after birth and the application of 1% silver nitrate solution or 1% tetracycline ointment to the eyes of all infants at the time of delivery is strongly recommended as a prophylactic measure. However, ocular prophylaxis provides poor protection against C. trachomatis conjunctivitis.

Infants born to mothers with gonococcal infection should receive additional treatment as follows:

Recommended regimen

• ceftriaxone 50 mg/kg by intramuscular injection as a single dose, to a maximum of 125mg.

Alternative regimen where ceftriaxone is not available

• kanamycin, 25 mg/kg by intramuscular injection as a single dose, to a maximum of 75mg

OR

• spectinomycin, 25 mg/kg by intramuscular injection as a single dose, to a maximum of 75mg.

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