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J Korean Med Assoc > Volume 51(10); 2008 > Article
Kim: Treatment and Management of Sexually Transmitted Diseases

Abstract

Sexually transmitted diseases (STDs) are the most common group of identifiable infectious diseases in many countries. Adolescents and young adults (15-24 years old) comprise only 25% of the sexually active population but represent almost 50% of all newly acquired STDs. In a law for prevention of infectious diseases in Korea, STDs include syphilis, gonorrhea, chancroid, nongonococcal urethritis, clamydial infection, genital herpes, and genital wart. Bacterial vaginosis, trichomoniasis, candidiasis, amebiasis, scabies, phthiriasis, granuloma inguinale, AIDS, and high risk human papilloma virus are also included in the STDs. Individuals infected with STDs are 5-10 times more likely than uninfected individuals to acquire or transmit HIV through sexual contacts. Their control is important considering the high incidences of acute infections, complications, and sequelae, their socioeconomic impact, and their role in increasing transmission of the HIV. The purpose of this paper is to summarize the treatment and management of STDs on the basis of Centers for Disease Control and Prevention treatment guidelines for sexually transmitted diseases published in 2006.

References

1. UNAIDS. Force for change: World AIDS Campaign with young people. UNAIDS 1998 theme. AIDS Anal Afr 1998;8:8-9.

2. Hillis SD, Wasserheit JN. Screening for Chlamydia-A Key to the prevention of pelvic inflammatory disease. N Engl J Med 1996;334:1399-1401.

3. Centers for Disease Control. Sexually transmitted disease treatment guidelines, 2006. MMWR 2006;55:11.

Table 1
Recommended regimens for chancroid*
jkma-51-884-i001-l.jpg

*Ciprofloxacin is contraindicated for pregnant and lactating women. Azithromycin and ceftriaxone offer the advantage of single-dose therapy. Worldwide, several isolates with intermediate resistance to either ciprofloxacin or erythromycin have been reported.

Table 2
Recommended regimens for genital herpes*
jkma-51-884-i002-l.jpg

*Treatment might be extended if healing is incomplete after 10 days of therapy.

Table 3
Recommended regimens for suppressive therapy of genital herpes
jkma-51-884-i003-l.jpg
Table 4
Recommended regimens for episodic therapy of genital herpes
jkma-51-884-i004-l.jpg
Table 5
Recommended regimens for daily suppressive therapy in persons infected with HIV
jkma-51-884-i005-l.jpg
Table 6
Recommended regimens for episodic infection in persons infected with HIV
jkma-51-884-i006-l.jpg
Table 7
Recommended regimen and alternative regimens for granuloma inguinale
jkma-51-884-i007-l.jpg
Table 8
Recommended regimen for primary and secondary syphilis
jkma-51-884-i008-l.jpg
Table 9
Recommended regimen for latent syphilis
jkma-51-884-i009-l.jpg
Table 10
Recommended regimen for tertiary syphilis
jkma-51-884-i010-l.jpg
Table 11
Oral desensitization protocol for patients with a positive skin test*
jkma-51-884-i011-l.jpg

Observation period: 30 minutes before parenteral administration of penicillin

*Reprinted with permission from the New England Journal of Medicine.

SOURCE: Wendel GO Jr. Stark BJ, Jamison RB, Melina RD, Sullivan TJ. Penicillin allergy and desensitization in serious infections during pregnancy. N Engl J Med 1985; 312; 1229-1232.

Interval between doses: 15 minutes; elapsed time: 3 hours and 45 minutes; and cumulative dose: 1.3 million units.

§The specific amount of drug was diluted in approximately 30mL of water amd then administered orally.

Table 12
Treatment regimens for nongonococcal urethritis
jkma-51-884-i012-l.jpg
Table 13
Recommended regimens for recurrent and persistent nongonococcal urethritis
jkma-51-884-i013-l.jpg
Table 14
Treatment regimens for chlamydial infections
jkma-51-884-i014-l.jpg
Table 15
Treatment regimens for chlamydial infections in pregnant women
jkma-51-884-i015-l.jpg
Table 16
Treatment regimens for uncomplicated gonococcal infections of the cervix, urethra, and rectum
jkma-51-884-i016-l.jpg
Table 17
Treatment regimens for bacterial vaginosis
jkma-51-884-i017-l.jpg
Table 18
Treatment regimens for pregnant women of bacterial vaginosis
jkma-51-884-i018-l.jpg
Table 19
Treatment regimens for trichomoniasis
jkma-51-884-i019-l.jpg
Table 20
Treatment Regimens for Vulvovaginal Candidiasis
jkma-51-884-i020-l.jpg
Table 21
Treatment regimens for external genital warts
jkma-51-884-i021-l.jpg
Table 22
Treatment regimens for scabies
jkma-51-884-i022-l.jpg
Table 23
Treatment Regimens for Pediculosis Pubis
jkma-51-884-i023-l.jpg


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