TABLE 3-17. TREATMENT OF UNCOMPLICATED GENITAL, ANAL, AND PHARYNGEAL<sub>b</sub> CHLAMYDIAL AND GONOCOCCAL INFECTIONS

TABLE 3-17. TREATMENT OF UNCOMPLICATED GENITAL, ANAL, AND PHARYNGEAL^b CHLAMYDIAL AND GONOCOCCAL INFECTIONS

For uncomplicated chlamydial infection:
azithromycin 1 g orally × 1 dose^a
or
doxycycline 100 mg orally twice daily × 7 days

For uncomplicated gonococcal infection:
cefixime 400 mg orally × 1 dose^a
or
ceftriaxone 125 mg IM × 1 dose^b
or
ciprofloxacin 500 mg orally × 1 dose^a-d
or
ofloxacin 400 mg orally × 1 dose^a,c,d
plus
(always treat for possible chlamydial coinfection)
azithromycin 1 g orally × 1 dose^a
or
doxycycline 100 mg orally twice daily × 7 days

For pregnancy:
erythromycin base 500 mg PO qid × 7 days;
or
amoxicillin 500 mg PO qid × 7 days

For sexual partners:
Contact, evaluate, and treat partners in the past 30 days for symptomatic (past 60 days for asymptomatic) infections for both chlamydial and gonococcal disease. Condoms should be used.

For follow-up:
Although not currently recommended by CDC, 4-7 days after treatment test of cure can be considered when compliance is not assured or documentation of partner(s) treatment is not possible.

^a It is now possible to treat both uncomplicated chlamydial and gonococcal infections with one-dose oral regimens. Cost factors must be evaluated locally. The effect of such regimens on incubating syphilis is not known. Although azithromycin and ofloxacin have been FDA-approved for those 16 years or older and 18 years or older, respectively, recent studies have shown them to be safe in younger adolescents as well.

^b ≥ 90% effective against gonococcal pharyngitis.

^c When STD identified, screen for syphilis by serology. Quinolones are not active against T. pallidum, are not contraindicated in pregnant/lactating women and in those ≤ 17 years (however, they have been used safely in adolescents).

^d Pregnant women should not be treated with quinolones.