Drug treatment of common STDs: Part I. Herpes, syphilis, urethritis, chlamydia and gonorrhea

In 1998, the Centers for Disease Control and Prevention released guidelines for the treatment of sexually transmitted diseases. Several treatment adva nces have been made since the previous guidelines were published. Part I of this two-part article describes current recommendations for the treatment of genital ulcer diseases, urethritis and cervicitis. Treatment advances in clude effective single-dose regimens for many sexually transmitted diseases and improved therapies for herpes infections. Two single-dose regimens, 1 g of oral azithromycin and 250 mg of intramuscular ceftriaxone, are effecti ve fmr the treatment of chancroid. A three-day course of 500 mg of oral cip rofloxacin twice daily may be used to treat chancroid in patients who are n ot pregnant. Parenteral penicillin continues to be the drug of choice for t reatment of all stages of syphilis. Three antiviral medications have been s hown to provide clinical benefit in the treatment of genital herpes: acyclo vir, valacyclovir and famciclovir. Valacyclovir and famciclovir are not yet recommended for use during pregnancy. Azithromycin in a single oral 1-g do se is now a recommended regimen for the treatment of nongonococcal urethrit is.