Regimen Pregnant Regimen Ffup

ULCERS
Primary and Secondary Benzathine Pen G 2.4 M units IM SD Second dose given 1 week after initial dose VDRL/RPR quantitative test 6-12 months
Syphilis after treatment
Pen Allergy: Doxycycline 100mg BID x 7 days If treatment failure entertained, do CSF
studies  if negative, give
retreatment: Benzathine Pen G 2.4M units
IM weekly x 3 weeks
Early Latent Syphilis Benzathine Pen G 2.4 M units IM SD Second dose given 1 week after initial dose

Late Latent Syphilis Benzathine Pen G 2.4 M units weekly x 3 Benzathine Pen G 2.4 M units weekly x 3 Serologic titers 6, 12, 24 months
weeks (total of 7.2 M units) weeks (total of 7.2 M units)
CONGENITAL SYPHILIS:
If missed dose beyond 10 days after last If with missed dose, RESTART course blunted upper incisor teeth known as
dose, RESTART course Hutchinson's teeth
inflammation of the cornea known as
Pen Allergy: Doxycycline 100mg BID x 28days interstitial keratitis
deafness from auditory nerve disease
frontal bossing (prominence of the brow
ridge)
saddle nose (collapse of the bony part
of nose)
hard palate defect
swollen knees
saber shins
short maxillae
protruding mandible
Neurosyphilis Aqueous Crystalline Pen G 18-24M units OD CSF examination every 6 months (CHON and
administered as 3-4 M units IV every 4 hours WBC counts)
or continuous infusion x 10-14 days

Alt: Procaine Pen G 2.4 M IM OD x 10-14days

 PLUS Probenecid 500mg PO QID

Then Benzathine Pen G 2.4 M units weekly x

3 weeks

Herpes Simplex Virus Acyclovir 400mg TID x 7-10 days
Alternatives:
Acyclovir 200mg 5x/day x 7-10 days
Valacyclovir 1 g BID x 7-10 days
Famiciclovir 250mg TID x 7-10days
Acyclovir 400mg TID x 7-10 days
Daily suppressive Therapy (12 months):
Acyclovir 400mg TID
Valacyclovir 500mg BID
CONGENITAL HERPES:
Localized disease – skin, eyes, mouth
Disseminated disease - hepatitis,
pneumonitis, disseminated intravascular
coagulation
Encephalitis

IV Acyclovir 5-10mg/kg 18 x 2-7days then

shift to oral 10 days (21 days for enceph)

Daily suppressive Therapy (12 months):

Acyclovir 400mg BID
Valacyclovir 500mg-1g OD
Famiciclovir 250mg BID

Granuloma Inguinale Azithromycin 1g/week x 3 weeks Until symptoms resolve

(Donovanosis)
Alternative: Inform Partner: 60 days from onset of Sx
Doxycycline 100mg BID x 3 weeks
Ciprofloxacin 750mg BID x3 weeks
Erythromycin 500mg QID
TMP SMZ BID

Lymphogranuloma Doxycycline 100mg BID x 21 d Until symptoms resolve

Venereum
Alternative: Inform Partner: 60 days from onset of Sx
Erythromycin 500mg QID x 21 d
Chancroid Azithromycin 1g SD 3-7days
Ulcer heals in 2 weeks
Alternative:
Ceftriaxone 250mg IM SD Inform Partners: 10days from onset of
Ciprofloxacin 500mg BID x 3d symptoms
Erythromycin 500mg TID x 7d
VAGINITIS
Bacterial Vaginitis Metronidazole 500mg BID x 7d Avoid alcoholic beverage (disulfram-like
Metronidazole gel 0.75% 5g applicator per reaction) until 24h-72h
vagina OD x 5d Avoid sexual contact
Clindamycin cream 2% 5g applicator per Avoid douching
vagina at HS for 7d Wash

Alternative:
Tinidazole 2g PO OD x 2d
Tinidazole 1g OD x 5d
Clindamycin ovules 100mg intravaginally at
HS x 3d

Trichomoniasis Metronidazole 2d SD
Tinidazole 2g SD

Alternative:
Metronidazole 500mg BID x 7d

Candidiasis Fluconazole 150mg SD Miconazole 1.2mg vag suppository SD Recurrent:

Miconazole 1.2mg vag suppository SD
Alternative:
Clotrimazole 1% 5g x 7-14d
Nystatin 100,000 U OD x 14 days
Complicated VVC:
Eradication:
Fluconazole 150mg/tab days 1, 4, 7
Fluconzaole 200mg day 1,4,7 then
maintenance once a week for 6 months
Topical 7-14days
 Topical Azoles x 10-14 days
Uncomplicated VVC: Maintenance:
Topical antifungal 1-3d Fluconazole 150mg/tab OD weekly x 6 mos
Fluconazole 150mg SD

Complicated VVC:
Topical azole 7-14d
Fluconazole 150mg PO SD then 150mg after
72h

Non-albicans:
Boric acid 600mg per vagina at HS x 14days
OTHERS
PID OP Regimen: Treat partner as OP regimen x 7 days
Ceftriaxone 250mg/IM SD + Doxycycline Ceftriaxone 250mg/IM SD + Doxycycline
100mg/tab BID x 14 days w/ or w/o 100mg/tab BID x 7 days
Metronidazole 500mg/tab BID x 14 days
Cefoxitin 2gm/IM SD+ Probenecid 1gm PO
SD+ Doxycycline 100mg/tab BID x 14 days w/
or w/o Metronidazole 500mg/tab BID x 14
days

Regimen A:
Cefotetan 2g IV q 12 + Doxycycline 100mg
BID x 14d
Cefoxitin 2g IV q6 + Doxycycline 100mg BID x
14d

Regimen B:
Clindamycin 900mg q6h
Gentamicin 2g/kg LD then 1.5kg IV q8
 Alternative:
Ampicillin/Sulbactam 3g IV q6 + Doxycycline
100mg BID x 14d

Genital Warts Imiquimod 3.75% or 5% cream at HS 3x a TCA 80-90% solution

week for 16weeks

Podofilox 0.5% solution or gel 2x a day for 3

days then 4 days no treatment for 4 cycles

Sinecatechins 15% ointment, 0.5cm TID

TCA 80-90% solution

Septic Abortion No sepsis:

Pen G 4M units IV q6

With sepsis:
Pen G 4M units IV q6
Gentamicin 2mg/kg q8

With severe sepsis:

Pen G 4M units q6
Gentamicin 2mg/kg q8
Clindamycin 900mg IV q8 OR Metronidazole
500mg IV q8

Alternative:
Meropenem 500mg-1g IV q8
Imipenem 500mg IV q6
Ertapenem 1-2mg IV OD
Pip Tazo 2.25-4.5mg IV q6