Last Updated on February 25, 2019 by FRCEM Intermediate

Chlamydia infection

• Doxycycline 100 mg bd for 7 days OR azithromycin 1 g stat

Gonorrhea – Neisseria gonorrhoeae

• Ceftriaxone 500 mg intramuscularly PLUS azithromycin 1 g orally

Pelvic inflammatory disease

• oral ofloxacin 400 mg bd and metronidazole 400 mg bd for 14 days OR
• IM ceftriaxone 500 mg stat, followed by oral doxycycline 100 mg bd and metronidazole 400 mg bd for 14 days

Males- Epididymo-orchitis: 

• Ceftriaxone 250 mg IM single dose and doxycycline 100 mg bd for 10 – 14 days if the sexually transmitted pathogen is likely, or
• ofloxacin 200 mg bd for 14 days or ciprofloxacin 500 mg bd for 10 days the f enteric pathogen is most likely

Management

• Treat infection with appropriate formulary antibiotics
• Arrange to screen for other STIs
• Consider the risk of pregnancy
• Encourage patient-led partner notification
• Consider risk of sexual abuse, rape or non-consensual sex (especially in individuals < 16 years)
• Give advice regarding protection against further STIs (+contraception)
• Arrange follow-up if a test of cure is indicated
• Assess and manage complications