Since the 1993 treatment guidelines for sexually transmitted diseases were
published by the Centers for Disease Control and Prevention, experience has
indicated that the regimens recommended then remain largely effective. The
recommended therapies-with azithromycin (1 g orally, once), ceftriaxone (2
50 mg intramuscularly, once), or erythromycin (500 mg orally, four times a
day for 7 days)-appear highly effective in the United States; limited data
from Kenya suggest that the ceftriaxone regimen may not be as effective the
re as it once was, The alternative regimen of ciprofloxacin proposed in 199
3 (500 mg orally, twice a day for 3 days) is as effective as the recommende
d therapies, but new information indicates that single-dose therapy with 50
0 mg orally is not as effective as the use of either larger single doses or
more prolonged therapy. Persons who are infected with human immunodeficien
cy virus (HIV) do not respond as well as those who are not HIV-infected, an
d males who are uncircumcised appear not to respond as well as those who ar
e circumcised.