Vol. 59 / RR-12 Recommendations and Reports 1
Sexually Trasmitted Diseases Treatmet Guidelies, 2010
Prepared by Kimberly A. Workowski, MD
Stuart Berman, MD
Division o SD PreventionNational Center or HIV/AIDS, Viral Hepatitis, SD, and B Prevention
Emory University, Atlanta, Georgia
Tese guidelines or the treatment o persons who have or are at risk or sexually transmitted diseases (SDs) were updated by CDC ater consultation with a group o proessionals knowledgeable in the eld o SDs who met in Atlanta on April 18–30, 2009. Te inormation in this report updates the 2006 Guidelines or reatment o Sexually ransmitted Diseases (
2006;55[No. RR–11]). Included in these updated guidelines is new inormation regarding 1) the expanded diagnostic evaluation or cervicitis and trichomoniasis; 2) new treatment recommendations or bacterial vaginosis and genital warts; 3) the clinical ecacy o azithromycin or chlamydial inections in pregnancy; 4) the role o
and trichomoniasis inurethritis/cervicitis and treatment-related implications; 5) lymphogranuloma venereum proctocolitis among men who have sex with men; 6) the criteria or spinal fuid examination to evaluate or neurosyphilis; 7) the emergence o azithromycin-resistant
; 8) the increasing prevalence o antimicrobial-resistant
; 9) the sexual transmissiono hepatitis C; 10) diagnostic evaluation ater sexual assault; and 11) SD prevention approaches.
Te term sexually transmitted diseases (SDs) is used toreer to a variety o clinical syndromes caused by pathogensthat can be acquired and transmitted through sexual activity.Physicians and other health-care providers play a critical role inpreventing and treating SDs. Tese guidelines or the treat-ment o SDs are intended to assist with that eort. Althoughthese guidelines emphasize treatment, prevention strategies anddiagnostic recommendations also are discussed.Tese recommendations should be regarded as a source o clinical guidance and not prescriptive standards; health-careproviders should always consider the clinical circumstances o each person in the context o local disease prevalence. Tey areapplicable to various patient-care settings, including amily-planning clinics, private physicians’ oces, managed care orga-nizations, and other primary-care acilities. Tese guidelinesocus on the treatment and counseling o individual patientsand do not address other community services and interven-tions that are essential to SD/human immunodeciency virus(HIV) prevention eorts.
hese guidelines were developed using a multistageprocess. Beginning in 2008, CDC sta members and publicand private sector experts knowledgeable in the eld o SDssystematically reviewed literature using an evidence-basedapproach (e.g., published abstracts and peer-reviewed journalarticles), ocusing on the common SDs and inormation thathad become available since publication o the
2006 Guidelines or reatment o Sexually ransmitted Diseases
CDC sta members and SD experts developed background papers andtables o evidence that summarized the type o study (e.g.,randomized controlled trial or case series), study populationand setting, treatments or other interventions, outcomemeasures assessed, reported ndings, and weaknesses and biasesin study design and analysis. CDC sta then developed a dratdocument on the basis o this evidence-based review. In April2009, this inormation was presented at a meeting o invitedconsultants (including public- and private-sector proessionalsknowledgeable in the treatment o patients with SDs), whereall evidence rom the literature reviews pertaining to SDmanagement was discussed.Specically, participants identied key questions regardingSD treatment that emerged rom the literature reviews anddiscussed the inormation available to answer those ques-tions. Discussion ocused on our principal outcomes o SDtherapy or each individual disease: 1) treatment o inectionbased on microbiologic eradication; 2) alleviation o signsand symptoms; 3) prevention o sequelae; and 4) prevention
Kimberly Workowski, MD, Division o SD Prevention, National Center or HIV/AIDS, Viral Hepatitis,SD, and B Prevention, 10 Corporate Square, Corporate SquareBlvd, MS E02, Atlanta, GA 30333. elephone: 404-639-1898;Fax: 404-639-8610; email@example.com.