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Treatment of Sexually Transmitted Infections Made Easy for CSA

sex-cheatsheet

 

Sexually Transmitted Infections Treatment Made Easy!

Yes, In your exams, STI treatment part may be 1/100th of the marks you get.

Do not worry too much about it to start with ūüôā

Bookmark it in your lovely BNF…. ( check in BNF always if unsure)

Do not forget to take it with you AND look into it in your EXAM if needed!

 

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Click the image to get the cheat sheet!

 

 

The vital points to cover in STI case are:

1. To be Super Sensitive

2. Non-judgemental attitude

3. Go with the flow

4. Show 100% empathy

5. Explore sexual history sensitively

6. Identify Patient’s needs, any Ethical dilemmas…

7. Make sure to rule out  risks like Pregnancy, Abuse, Rape etc

8. Involve relevant support team

9. Make a proper follow-up plan

10. If dealing sensitive cases like recent rape – ¬†”GIVE ADEQUATE TIME FOR THE PATIENT”

Click here to read more – STI RISK – Cheat sheet

 

Get BASHH Guidelines HERE,  other USEFUL TIPS & LINKS  & Contraception Guidelines

 

MOST IMPORTANT POINTS

 

1. Bacterial Vaginosis is NOT a STI,

BUT   Trichomonus Vaginalis is an STI

The patient might be worrying that it might be a STI.

So explore the ideas, concerns and expectations in detail.

Tailor your explanation according to it.

2. Explore the use of Alcohol

 

Remember: Alcohol can cause antabuse like reaction with Metronidazole.

So alert the patient to avoid it.

If they say they cannot – Then go for alternatives like below –

***VERY IMPORTANT –¬†Practice this as a case

 

My Tip¬†ūüôā

 

Tinidazole for Trichomonas Vaginalis    ( T for TV)

Clindamycin for Bacterial¬†Vaginosis. ¬† ¬†( B –> C)

3. check ALLERGY status, Drug interactions, Pregnancy status……

4. Rule out STI risk in reactive arthritis in young ( Practise this as a case)

5. Suggest referral to GUM clinic for contact tracing

6. Treat partners simultaneously.

7. Check previous STI Rx and rule out any resistance to Antibiotics!

8. Certain Vaginal preparations may affect latex Condoms Р so alert the patients.

 

SEXUALLY TRANSMITTED INFECTIONS – TREATMENT MADE EASY

 

1. TRICHOMONAS VAGINALIS   (*STI*)

Metronidazole 2 gm stat or 400mg BD for 7 days.

Alternative if alcohol use – Tinidazole 2 gm stat ( Practise as a case)

or Clotrimazole pessary 100mg nocte for 6 days.

If Pregnant – Avoid high dose Metronidazole or use pessary for SYMPTOMATIC Rx & Treat Post natally.

 

 

2. CHLAMYDIA 

Azithromycin 1 gm stat or

Doxycycline 100mg BD for 7 days.

If pregnant Р Treat for 14 days with

Erythromycin  OR AMOXICILLIN Р 250MG QDS  or 500mg BD

 

 

3. GONORRHEA

Ceftriaxone 250mg IM, Ciprofloxacin 500mg stat, Doxycycline 100mg BD  for 7 days.

 

4. SYPHILIS

EARLY – Doxycycline/ Erythromycin for 14 days

LATENT  Р BBP weekly for 2 weeks & Doxycycline for 28 days.

ASYMPTOMATIC CONTACT FOR INFECTIOUS SYPHILIS –¬†Doxycycline for 14 days.

(Practice this as a case)

 

 

5.PID

(Be familiar with local protocol)

Doxycycline 100mg BD or  Ofloxacin  400mg BD 14 days

plus Metronidazole 400mg BD for 7 days.

 

6. EPIDIDYMO- ORCHITIS

( STI until proven otherwise in young men)

Ofloxacin 200mg BD for 14 days.

or

Ceftriaxone 250mg IM stat + Doxycyline 100mg BD for 14 days.

 

 

7. HERPES SIMPLEX

Treat within 72 hrs after rash.

Acyclovir 200mg – 5 times for 5 days.

Please offer Analgesia – Cocodamol or local lignocaine gel or EMLA

Zovirax cream in recurrences (sensilube)

If Pregnant – Acyclovir 200mg 5times for 5 days

Prophylaxis – Acyclovir 40mg BD – No need to monitor LFT.

 

 

8. GENITAL WARTS

Warticon ( Podophyllotoxin 0.1%)  or

Imiquimod (Aldara) – Perianal recurrences

3 days/week for one month and review

In Clinic – Cryotherapy or 95% Trichloro Acetic acid.

 

 

9. VAGINAL CANDIDIASIS

Clotrimazole cream 10% or pessary 500mg stat

or  Fluconazole 150 mg orally stat

or   Itraconazole 200mg BD for one day.

USE Canestan HC or sensilube for Inflammation.

 

 

RECURRENT VAGINAL CANDIDIASIS  (Practice this case)

РAny of the above Р BUT  Treat ONCE monthly for SIX months

All topical or oral azoles give 80-95% cure.

In pregnancy- avoid oral azoles.

In Rx failure – send swab for culture.

 

 

10. BACTERIAL VAGINOSIS    (***NOT STI ***)

Metronidazole  Р 2gm stat, or 400mg BD for 7 days

or topically as 5 gm gel ( zidovel) PV for 5 nights.

Alternative : Clindamycin 2% cream  PV  ( Practice this as a case) for 7 days.

(Practice this case)

If Pregnant Р Amoxicillin 500mg QDS for 5 days.

 

 

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Talk soon,

hemasign

Dr. Hema 

 

P.S.

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