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Learn about treatment options for Urinary Tract Infections (UTIs) and Sexually Transmitted Diseases (STDs), including antibiotics and management strategies for different conditions and patient populations.
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UTIs (Cystitis) Fluoroquinolones, TMP/SMX, nitrofurantoin, amoxicillin-clavulanate, cephalosporins, tetracyclines, and fosfomycin. Most women: 3 days women who have a history of previous UTI caused by antibiotic-resistant organisms or more than 7 days of symptoms, and in men: 7 days
UTIs (HCA) Mild to moderate illness without alterations in mental status or hemodynamic status may be treated with a urinary fluoroquinolone, such as ciprofloxacin or levofloxacin, or a broad-spectrum cephalosporin such as cefepime. If the patient has evidence of pyelonephritis or urosepsis, one should consider a broader-spectrum drug such as piperacillin-tazobactam or a carbapenem for empiric treatment. If the urine Gram stain shows gram-positive cocci (most likely enterococci or staphylococci), treatment with vancomycin is reasonable.
STDs (urethritis) Ceftriaxone, 125mg IM; or Cefpodoxime, 400 mg PO; or Cefixime, 400 mg PO Plus Azithromycin, 1 g PO; or Doxycycline, 100 mg bid PO for 7 days All sex partners within the preceding 60 days should be referred for evaluation, testing, and empiric treatment with a drug regimen effective against chlamydia and gonorrhea.
STDs (Chancroid) Partners: Rx if they had sexual contact with the patient during the 10 days preceding the patient’s onset of symptoms.
STDs (Granuloma Inguinale (Donovanosis)) Persons who have had sexual contact with a patient who has granuloma inguinale within the 60 days before onset of the patient’s symptoms should be examined and offered therapy.
STDs (Lymphogranuloma Venereum) Persons who have had sexual contact with a patient who has LGV within the 60 days before onset of the patient’s symptoms should be examined, tested for urethral or cervical chlamydial infection, and treated with a chlamydia regimen (azithromycin 1 gm orally single dose or doxycycline 100 mg orally twice a day for 7 days).
STDs (Trichomoniasis) male partners should be evaluated and treated with either tinidazole in a single dose of 2 g orally or metronidazole twice a day at 500 mg orally for 7 days.