Management of Sexually Transmitted Infections

Diagnostic Approach

The Centers for Disease Control and Prevention recommends that nucleic acid amplification tests (NAATs) should be performed from all sites of penetration or attempted penetration, with high sensitivity (86.1%-100%) and specificity (97.1%-100%) for diagnosis 1, 2, 3.
The American College of Obstetricians and Gynecologists suggests that wet mount examination should be performed when vaginal discharge or malodor is present to evaluate for trichomoniasis, bacterial vaginosis, and yeast 1, 2, 3.

The Centers for Disease Control and Prevention recommends ceftriaxone 125 mg IM plus doxycycline 100 mg orally twice daily for 7 days as the treatment for urethritis and cervicitis when both gonorrhea and chlamydia are suspected 1, 2, 3.
The Infectious Diseases Society of America suggests that doxycycline 100 mg orally twice daily for 7 days is first-line therapy for uncomplicated chlamydia 4.

The Centers for Disease Control and Prevention recommends permethrin 1% cream rinse applied to affected areas and washed off after 10 minutes as the first-line treatment for pediculosis pubis 2.
The American Academy of Pediatrics suggests that permethrin is the preferred treatment for pregnant women, lactating women, infants, and young children with scabies 1, 3.

The Centers for Disease Control and Prevention recommends that vaccination (hepatitis B, HPV) and preexposure prophylaxis are effective prevention measures 1.
The American College of Obstetricians and Gynecologists suggests that barrier contraception should be promoted as transmission can occur through asymptomatic viral shedding 1.

The Centers for Disease Control and Prevention recommends that sexual partners within the preceding month must be examined and treated for confirmed STIs 1, 2, 5.

The Infectious Diseases Society of America suggests that acyclovir should be administered to patients with suspected or confirmed HSV infection 6.
The Centers for Disease Control and Prevention recommends that hepatitis B vaccine should be administered for postexposure prophylaxis when indicated 1, 3.

The American College of Obstetricians and Gynecologists recommends that empiric treatment with topical antifungal therapy (clotrimazole 1% cream or miconazole 2% cream) is the appropriate first-line approach for vulvovaginal candidiasis 7.