CDC STD Treatment Guideline 2021

 

Written by: Patrick Monahan, MD; Edited by: Timothy Khowong, MD

 

Introduction:

 Sexually transmitted diseases (STDs) continue to be a significant public health concern, affecting millions of individuals worldwide. To address this ongoing issue, the Centers for Disease Control and Prevention (CDC) plays a crucial role in establishing guidelines for the treatment of STDs. These guidelines serve as a comprehensive resource for healthcare providers and individuals seeking accurate information about STD treatment. In this blog post, we will delve into the CDC's guidelines, highlighting key recommendations and shedding light on the importance of early detection and appropriate treatment.

  1. The significance of early diagnosis: The CDC emphasizes the importance of early diagnosis for effective STD treatment. Timely identification of an infection not only helps prevent complications but also reduces the risk of transmitting the infection to others. Regular screenings, especially for high-risk individuals, can lead to early detection, prompt treatment, and improved outcomes.

  2. Individualized treatment plans: The CDC's guidelines advocate for individualized treatment plans based on various factors, including the type of STD, the individual's medical history, and coexisting conditions. Healthcare providers assess these factors to determine the most appropriate treatment regimen, ensuring optimal outcomes and reducing the risk of antimicrobial resistance.

  3. Antibiotic resistance and treatment updates: Antibiotic resistance is a growing concern in the realm of STD treatment. The CDC actively monitors and provides updates on emerging antibiotic resistance patterns to guide healthcare providers in selecting effective treatment options. Adhering to these recommendations is crucial to combat the rise of resistant strains and to preserve the effectiveness of available treatment options.

  4. Partner management and counseling: The CDC's guidelines stress the importance of partner management and counseling in the context of STD treatment. Promptly identifying and treating sexual partners is crucial to prevent reinfection and interrupt transmission chains. Additionally, counseling should be provided to individuals diagnosed with an STD to address their concerns, provide education about prevention, and promote responsible sexual behaviors.

  5. Specific treatment recommendations: The CDC recently updated the guidelines for STI treatments due to emergency resistance patterns. Unfortunately, the days of the one time treatment are no longer with us. Organism specific guidelines are as follows:

    Chlamydia:

    • Doxycycline 100mg BID for 7 days 

    • OR Azithromycin 1g oral single dose (pregnant patients) 

    • OR Levofloxacin 500mg for 7 days.

    • Also covers other causes of urethritis such as Mycoplasma Genitalium

    • Abstain from sexual activity for 7 days, treat any partners within 60 days of symptoms/diagnosis

    Gonorrhea: 

    • Ceftriaxone 500mg IM single dose (changed from old guidelines of ceftriaxone 250mg IM) 

    • OR Gentamicin 240mg IM + Azithromycin 2g oral 

    • OR Cefixime 800mg oral single dose

    • Also treat for chlamydia (Doxycycline OR azithromycin OR levofloxacin)

    • Abstain from sexual activity for 7 days, treat any partners within 60 days of symptoms/diagnosis

Pelvic Inflammatory Disease: IV and oral treatment have similar bioavailability, consider IV treatment and hospitalization when severe disease present (TOA, fever >38.5 C, unable to tolerate PO, pregnancy)

Parenteral:

    1. Ceftriaxone 1g daily AND Doxycycline 100mg oral BID AND metronidazole 500mg oral BID

Oral/IM:

    1. Ceftriaxone 500mg IM once plus

    2. Doxycycline 100mg BID x14 days AND Metronidazole 500mg BID x 14 days

Conclusion:

The CDC's guidelines for STD treatment serve as a valuable resource for healthcare providers, individuals diagnosed with an STD, and those seeking information on prevention and treatment. By following these guidelines, healthcare professionals can provide evidence-based care, improve patient outcomes, and contribute to the overall effort of reducing the burden of STDs on public health. Moreover, individuals can better understand the importance of early diagnosis, adherence to treatment regimens, and responsible sexual behaviors to prevent the spread of STDs in our communities. Remember, knowledge and awareness are key in combating the prevalence of STDs, and the CDC's guidelines are an essential tool in achieving that goal.

 

References:

  1. Korenromp EL, Sudaryo MK, de Vlas SJ, et al. What proportion of episodes of gonorrhoea and chlamydia becomes symptomatic? International journal of STD & AIDS 2002;13:91-101.

  2. Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA. Sexually Transmitted Infections Treatment Guidelines, 2021.

  3. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines. MMWR Recomm Rep. 2015;64(RR3):1–137.

 
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