Syphilis:
- Pen G x 1 or doxycycline
- In more severe cases may treat weekly for 3 weeks.
- For neurosyphilis, PenG infusion for 10-14 days.
- Treat all sex partners within last 90 days.
- If a patient with neurosyphilis is allergic to PCN, desensitization is best. Neurosyphilis is not as vulnerable to doxy.
Chlamydia:
- Azithromycin X 1
- Doxy for 7-21 days
- If pregnant, azithromycin only.
- Add amoxicillin to cover N. gonorrhea
Gonorrhea:
- Ceftriaxone +/- azithromycin (treats gonorrhea and chlamydia) or doxy for 7 days.
Vaginosis:
- Metronidazole for 7 days (trichomoniasis X 1 only)
Prostatitis:
- Acute: hydration, analgesics, bed rest
- Men < 35 years: ceftriaxone and doxycycline
- Men > 35 years: Bactrim, fluoroquinolones (especially in resistance) or Ampicillin plus gentamicin if enterococci suspected.
- Chronic: Bactrim, but if Bactrim failure, nitrofurantoin, fluoroquinolones if you need pseudo coverage
- For chronic, non-bacterial: terazosin +/- valium +/- stool softeners
Pelvic Inflammatory Disease:
- Cefoxotan + doxycycline for 14 days
- Ceftriaxone + doxycycline for 14 days