Sexually transmitted diseases treatment guidelines (2015)

Authors

  • Kimberly A. Workowski Emory University, Atlanta, Georgia, United States
  • Gail A. Bolan Emory University, Atlanta, Georgia, United States

DOI:

https://doi.org/10.18370/2309-4117.2015.24.51-56

Keywords:

sexually transmitted diseases, guideline, U.S. Centers for Disease Control and Prevention

Abstract

These guidelines for the treatment of persons who have or are at risk for sexually transmitted diseases (STDs) were updated by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on April 30–May 2, 2013. The information in this report updates the Sexually Transmitted Diseases Treatment Guidelines, 2010.

These updated guidelines discuss 1) alternative treatment regimens for Neisseria gonorrhoeae; 2) the use of nucleic acid amplification tests for the diagnosis of trichomoniasis; 3) alternative treatment options for genital warts; 4) the role of Mycoplasma genitalium in urethritis/cervicitis and treatment-related implications; 5) updated HPV vaccine recommendations and counseling messages; 6) the management of persons who are transgender; 7) annual testing for hepatitis C in persons with HIV infection; 8) updated recommendations for diagnostic evaluation of urethritis; and 9) retesting to detect repeat infection. Physicians and other health-care providers can use these guidelines to assist in the prevention and treatment of STDs.

Author Biographies

Kimberly A. Workowski, Emory University, Atlanta, Georgia

MD, Division of STD Prevention National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

Gail A. Bolan, Emory University, Atlanta, Georgia

MD, Division of STD Prevention National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

References

  1. LeFevre, M.L. “USPSTF: screening for chlamydia and gonorrhea.” Ann Intern Med, 161(2014): 902–910.
  2. CDC. Sexually transmitted disease surveillance 2013. Atlanta. US Department of Health and Human Services (2014).
  3. Tully, J.G., Taylor-Robinson, D., Cole, R.M., et al. “A newly discovered mycoplasma in the human urogenital tract.” Lancet, 1(1981): 1288–1291.
  4. Taylor-Robinson, D., Jensen, J.S. “Mycoplasma genitalium: from chrysalis to multicolored butterfly.” Clin Microbiol Rev, 24(2011):498–514.
  5. Huppert, J.S., Mortensen, J.E., Reed, J.L., et al. “Mycoplasma genitalium detected by transcription-mediated amplification is associated with Chlamydia trachomatis in adolescent women.” Sex Transm Dis, 35(2008): 250–254.
  6. Mena, L., Wang, X., Mroczkowski, T.F., et al. “Mycoplasma genitalium infections in asymptomatic men and men with urethritis attending a sexually transmitted diseases clinic in New Orleans.” Clin Infect Dis, 35(2002): 1167–1173.
  7. Falk, L. “The overall agreement of proposed definitions of mucopurulent cervicitis in women at high risk of chlamydia infection.” Acta Derm Venereol, 90(2010): 506–511.
  8. Mena, L.A., Mroczkowski, T.F., Nsuami, M., et al. “A randomized comparison of azithromycin and doxycycline for the treatment of Mycoplasma genitalium-positive urethritis in men.” Clin Infect Dis, 48(2009): 1649–1654.
  9. Schwebke, J.R., Rompalo, A., Taylor, S., et al. “Re-evaluating the treatment of nongonococcal urethritis: emphasizing emerging pathogens – a randomized clinical trial.” Clin Infect Dis, 52(2011): 163–170.
  10. Manhart, L.E., Gillespie, C.W., Lowens, M.S., et al. “Standard treatment regimens for nongonococcal urethritis have similar but declining cure rates: a randomized controlled trial.” Clin Infect Dis, 56(2013): 934–942.
  11. Jernberg, E., Moghaddam, A., Moi, H. “Azithromycin and moxifloxacin for microbiological cure of Mycoplasma genitalium infection: an open study.” International journal of STD and AIDS, 19(2008): 676–679.
  12. Bradshaw, C.S., Chen, M.Y., Fairley, C.K. “Persistence of Mycoplasma genitalium following azithromycin therapy.” PLoS One, 3(2008): e3618.
  13. Ross, J.D., Cronje, H.S., Paszkowski, T., et al. “Moxifloxacin versus ofloxacin plus metronidazole in uncomplicated pelvic inflammatory disease: results of a multicentre, double blind, randomised trial.” Sex Transm Infect, 82(2006): 446–451.
  14. Briggs, G.C., Freeman, R.K., Yaffe, S.J. Drugs in Pregnancy and Lactation, 9th ed. Philadelphia, PA. Lippincott Williams & Wilkins (2011).
  15. Papp, J.R., Schachter, J., Gaydos, C., et al. “Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae –2014.” MMWR Recomm Rep, 63(2014): RR–02.
  16. Nye, M.B., Schwebke, J.R., Body, B.A. “Comparison of APTIMA Trichomonas vaginalis transcriptionmediated amplification to wet mount microscopy, culture, and polymerase chain reaction for diagnosis of trichomoniasis in men and women.” Am J Obstet Gynecol, 200(2009): e181–7.
  17. Schachter, J., Moncada, J., Liska, S., et al. “Nucleic acid amplification tests in the diagnosis of chlamydial and gonococcal infections of the oropharynx and rectum in men who have sex with men.” Sex Transm Dis, 35(2008): 637–642.
  18. Mimiaga, M.J., Mayer, K.H., Reisner, S.L., et al. “Asymptomatic gonorrhea and chlamydial infections detected by nucleic acid amplification tests among Boston area men who have sex with men.” Sex Transm Dis, 35(2008): 495–498.
  19. Bachmann, L.H., Johnson, R.E., Cheng, H., et al. “Nucleic acid amplification tests for diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis rectal infections.” J Clin Microbiol, 48(2010): 1827–1832.
  20. Bachmann, L.H., Johnson, R.E., Cheng, H., et al. “Nucleic acid amplification tests for diagnosis of Neisseria gonorrhoeae oropharyngeal infections.” J Clin Microbiol, 47(2009): 902–907.
  21. Chernesky, M., Freund, G.G., Hook, E. 3rd, et al. “Detection of Chlamydia trachomatis and Neisseria gonorrhoeae infections in North American women by testing SurePath liquid-based Pap specimens in APTIMA assays.” J Clin Microbiol, 45(2007): 2434–2438.
  22. Geisler, W.M., Wang, C., Morrison, S.G., et al. “The natural history of untreated Chlamydia trachomatis infection in the interval between screening and returning for treatment.” Sex Transm Dis, 35(2008): 119–123.
  23. Jacobson, G.F., Autry, A.M., Kirby, R.S., et al. “A randomized controlled trial comparing amoxicillin and azithromycin for the treatment of Chlamydia trachomatis in pregnancy.” Am J Obstet Gynecol, 184(2001): 1352–1354.
  24. Kacmar, J., Cheh, E., Montagno, A., et al. “A randomized trial of azithromycin versus amoxicillin for the treatment of Chlamydia trachomatis in pregnancy.” Infect Dis Obstet Gynecol, 9(2001): 197–202.
  25. Rahangdale, L., Guerry, S., Bauer, H.M., et al. “An observational cohort study of Chlamydia trachomatis treatment in pregnancy.” Sex Transm Dis, 33(2006): 106–110.
  26. Aggarwal, A., Spitzer, R.F., Caccia, N., et al. “Repeat screening for sexually transmitted infection in adolescent obstetric patients.” J Obstet Gynaecol Can, 32(2010):956–961.
  27. Hood, E.E., Nerhood, R.C. “The utility of screening for chlamydia at 34-36 weeks gestation.” W V Med J, 106(2010): 10–11.
  28. Satterwhite, C.L., Torrone, E., Meites, E., et al. “Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008.” Sex Transm Dis, 40(2013): 187–193.
  29. CDC. Update to CDC’s Sexually transmitted diseases treatment guidelines, 2010. “Oral cephalosporins no longer a recommended treatment for gonococcal infections.” MMWR Morbid Mortal Wkly Rep, 61(2012): 590–594.
  30. Muratani, T., Akasaka, S., Kobayashi, T., et al. “Outbreak of cefozopran (penicillin, oral cephems, and aztreonam)-resistant Neisseria gonorrhoeae in Japan.” Antimicrob Agents Chemother, 45(2001):3603–3606.
  31. Deguchi, T., Yasuda, M., Yokoi, S., et al. “Treatment of uncomplicated gonococcal urethritis by double-dosing of 200 mg cefixime at a 6-h interval.” J Infect Chemother, 9(2003): 35–39.
  32. Yokoi, S., Deguchi, T., Ozawa, T., et al. “Threat to cefixime treatment for gonorrhea.” Emerg Infect Dis, 13(2007): 1275–1277.
  33. Lo, J.Y., Ho, K.M., Leung, A.O., et al. “Ceftibuten resistance and treatment failure of Neisseria gonorrhoeae infection.” Antimicrob Agents Chemother, 52(2008): 3564–3567.
  34. Unemo, M., Golparian, D., Syversen, G., et al. “Two cases of verified clinical failures using internationally recommended first-line cefixime for gonorrhoea treatment, Norway, 2010.” Euro Surveillance Online, 15(2010): 19721.
  35. Ison, C.A., Hussey, J., Sankar, K.N., et al. “Gonorrhoea treatment failures to cefixime and azithromycin in England, 2010.” Euro Surveillance Online, 16(2011): 19833.
  36. Forsyth, S., Penney, P., Rooney, G. “Cefixime-resistant Neisseria gonorrhoeae in the UK: a time to reflect on practice and recommendations.” International journal of STD and AIDS, 22(2011): 296–297.
  37. Unemo, M., Golparian, D., Stary, A., et al. “First Neisseria gonorrhoeae strain with resistance to cefixime causing gonorrhoea treatment failure in Austria, 2011.” Euro Surveillance Online, 16(2011): 19998.
  38. Unemo, M., Golparian, D., Nicholas, R., et al. “High-level cefixime- and ceftriaxone-resistant Neisseria gonorrhoeae in France: novel penA mosaic allele in a successful international clone causes treatment failure.” Antimicrob Agents Chemother, 56(2012): 1273–1280.
  39. Lewis, D.A., Sriruttan, C., Muller, E.E., et al. “Phenotypic and genetic characterization of the first two cases of extended-spectrumcephalosporin-resistant Neisseria gonorrhoeae infection in South Africa and association with cefixime treatment failure.” J Antimicrob Chemother, 68(2013):
  40. –1270.
  41. Ota, K.V., Fisman, D.N., Tamari, I.E., et al. “Incidence and treatment outcomes of pharyngeal Neisseria gonorrhoeae and Chlamydia trachomatis infections in men who have sex with men: a 13-year retrospective cohort study.” Clin Infect Dis, 48(2009): 1237–1243.
  42. Allen, V.G., Mitterni, L., Seah, C., et al. “Neisseria gonorrhoeae treatment failure and susceptibility to cefixime in Toronto, Canada.” JAMA, 309(2013): 163–170.
  43. Chen, M.Y., Stevens, K., Tideman, R., et al. “Failure of 500 mg of ceftriaxone to eradicate pharyngeal gonorrhoea, Australia.” J Antimicrob Chemother, 68(2013): 1445–1447.
  44. Tapsall, J., Read, P., Carmody, C., et al. “Two cases of failed ceftriaxone treatment in pharyngeal gonorrhoea verified by molecular microbiological methods.” J Med Microbiol, 58(5) (2009): 683–687.
  45. Ohnishi, M., Saika, T., Hoshina, S., et al. “Ceftriaxone-resistant Neisseria gonorrhoeae, Japan.” Emerg Infect Dis, 17(2011): 148–149.
  46. Unemo, M., Golparian, D., Hestner, A. “Ceftriaxone treatment failure of pharyngeal gonorrhoea verified by international recommendations, Sweden, July 2010.” Euro Surveill, 16(2011).
  47. Unemo, M., Golparian, D., Potocnik, M., et al. “Treatment failure of pharyngeal gonorrhoea with internationally recommended first-line ceftriaxone verified in Slovenia, September 2011.” Euro Surveillance Online, 7(2012): 20200.
  48. Moran, J.S., Levine, W.C. “Drugs of choice for the treatment of uncomplicated gonococcal infections.” Clin Infect Dis, 20 (Suppl. 1) (1995): 47–65.
  49. Newman, L.M., Moran, J.S., Workowski, K.A. “Update on the management of gonorrhea in adults in the United States.” Clin Infect Dis, 44 (Suppl. 3) (2007): 84–101.
  50. Kirkcaldy, R.D., Weinstock, H.S., Moore, P.C., et al. “The efficacy and safety of gentamicin plus azithromycin and gemifloxacin plus azithromycin as treatment of uncomplicated gonorrhea.” Clin Infect Dis, 59(2014): 1083–1091.
  51. Erickson, S.H., Oppenheim, G.L., Smith, G.H. “Metronidazole in breast milk.” Obstet Gynecol, 57(1981): 48–50.
  52. Sutton, M., Sternberg, M., Koumans, E.H., et al. “The prevalence of Trichomonas vaginalis infection among reproductive-age women in the United States, 2001-2004.” Clin Infect Dis, 45(2007): 1319–1326.
  53. Ginocchio, C.C., Chapin, K., Smith, J.S., et al. “Prevalence of Trichomonas vaginalis and coinfection with Chlamydia trachomatis and Neisseria gonorrhoeae in the United States as determined by the Aptima Trichomonas vaginalis nucleic acid amplification assay.” J Clin Microbiol, 50(2012): 2601–2608.
  54. Meites, E., Llata, E., Braxton, J., et al. “Trichomonas vaginalis in selected U.S. sexually transmitted disease clinics: testing, screening, and prevalence.” Sex Transm Dis, 40(2013): 865–869.
  55. Cotch, M.F., Pastorek, J.G. 2nd, Nugent, R.P., et al. “Trichomonas vaginalis associated with low birth weight and preterm delivery.” Sex Transm Dis, 24(1997): 353–360.
  56. Hollman, D., Coupey, S.M., Fox, A.S., et al. “Screening for Trichomonas vaginalis in high-risk adolescent females with a new transcriptionmediated nucleic acid amplification test (NAAT): associations with ethnicity, symptoms, and prior and current STIs.” J Pediatr Adolesc Gynecol, 23(2010): 312–316.
  57. Roth, A.M., Williams, J.A., Ly, R., et al. “Changing sexually transmitted infection screening protocol will result in improved case finding for Trichomonas vaginalis among high-risk female populations.” Sex Transm Dis, 38(2011): 398–400.
  58. Schwebke, J.R., Hobbs, M.M., Taylor, S.N., et al. “Molecular testing for Trichomonas vaginalis in women: results from a prospective U.S. clinical trial.” J Clin Microbiol, 49(2011): 4106–4111.
  59. Huppert, J.S., Mortensen, J.E., Reed, J.L., et al. “Rapid antigen testing compares favorably with transcriptionmediated amplification assay for the detection of Trichomonas vaginalis in young women.” Clin Infect Dis, 45(2007): 194–198.
  60. Wood, B.A., Monro, A.M. “Pharmacokinetics of tinidazole and metronidazole in women after single large oral doses.” Br J Vener Dis, 51(1975): 51–53.
  61. Viitanen, J., Haataja, H., Mannisto, P.T. “Concentrations of metronidazole and tinidazole in male genital tissues.” Antimicrob Agents Chemother, 28(1985): 812–814.
  62. Mannisto, P., Karhunen, M., Mattila, J., et al. “Concentrations of metronidazole and tinidazole in female reproductive organs after a single intravenous infusion and after repeated oral administration.” Infection, 12(1984): 197–201.
  63. Kirkcaldy, R.D., Augostini, P., Asbel, L.E., et al. “Trichomonas vaginalis antimicrobial drug resistance in 6 US cities, STD Surveillance Network, 2009–2010.” Emerg Infect Dis, 18(2012):939–943.
  64. Schwebke, J.R., Barrientes, F.J. “Prevalence of Trichomonas vaginalis isolates with resistance to metronidazole and tinidazole.” Antimicrob Agents Chemother, 50(2006): 4209–4210.
  65. Mann, J.R., McDermott, S., Gill, T. “Sexually transmitted infection is associated with increased risk of preterm birth in South Carolina women insured by Medicaid.” J Matern Fetal Neonatal Med, 23(2010): 563–568.
  66. Mann, J.R., McDermott, S., Barnes, T.L., et al. “Trichomoniasis in pregnancy and mental retardation in children.” Ann Epidemiol, 19(2009): 891–899.
  67. Mann, J.R., McDermott, S. “Are maternal genitourinary infection and pre-eclampsia associated with ADHD in school-aged children?” J Atten Disord, 15(2011): 667–673.
  68. Mann, J.R., McDermott, S., Zhou, L., et al. “Treatment of trichomoniasis in pregnancy and preterm birth: an observational study.” J Womens Health, 18(2009): 493–497.
  69. Gulmezoglu, A.M., Azhar, M. “Interventions for trichomoniasis in pregnancy.” Cochrane Database Syst Rev (2011): CD000220.
  70. Stringer, E., Read, J.S., Hoffman, I., et al. “Treatment of trichomoniasis in pregnancy in sub-Saharan Africa does not appear to be associated with low birth weight or preterm birth.” S Afr Med J, 100(2010): 58–64.
  71. Trintis, J., Epie, N., Boss, R., et al. “Neonatal Trichomonas vaginalis infection: a case report and review of literature.” Int J STD AIDS, 21(2010): 606–607.
  72. Carter, J.E., Whithaus, K.C. “Neonatal respiratory tract involvement by Trichomonas vaginalis: a case report and review of the literature.” Am J Trop Med Hygiene, 78(2008): 17–19.
  73. Goldenberg, R.L., Mwatha, A., Read, J.S., et al. “The HPTN 024 Study: the efficacy of antibiotics to prevent chorioamnionitis and preterm birth.” Am J Obstet Gynecol, 194(2006): 650–661.

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Published

2015-12-01

How to Cite

Workowski, K. A., & Bolan, G. A. (2015). Sexually transmitted diseases treatment guidelines (2015). REPRODUCTIVE ENDOCRINOLOGY, (24), 51–56. https://doi.org/10.18370/2309-4117.2015.24.51-56

Issue

No. 24 (2015)

Section

Inflammatory diseases

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Copyright (c) 2015 Kimberly A. Workowski, Gail A. Bolan

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