Syndrome

Causative organisms

Recommended treatment

Vaginal discharge syndrome

Neisseria gonorrhoeae

Chlamydia trachomatis

Trichomonas vaginalis

Treat with 3 drugs

Cefixime, oral, 400 mg single dose^**

Doxycycline, oral, 100 mg 12 hourly for 7 days

Metronidazole 2 g immediately as a single dose

In pregnancy/during breast feeding

Cefixime, oral, 400 mg single dose

Amoxicillin, oral 500 mg 8 hourly for 7 days^***

Metronidazole 2 g immediately as a single dose

People who are penicillin allergic may also react to cephalosporins.

^**If severe penicillin allergic, i.e. angioedema, anaphylactic shock or bronchospasm

Replace Cefixime with:

Ciprofloxacin, 500 mg oral (non-pregnant, non-breastfeeding)

Spectinomycin, IM 2 g single dose (pregnant, breastfeeding)

^***Penicillin allergic pregnant/breastfeeding women

Replace amoxicillin with:

Erythromycin, oral, 500 mg, 6 hourly for 7 days

Genital ulcer syndrome

Herpes simplex virus (HSV) type 2

Treponema pallidum (syphilis)

Treat with 3 drugs

Benzathine, Penicillin^**, 1 M, 2.4 MU immediately as a single dose Erythromycin, oral 500 mg 6 hourly for 7 days Acyclovir, oral, 400 mg 8 hourly for 7 days

^**If severe penicillin allergic, i.e. angioedema, anaphylactic shock or bronchospasm.

Non-pregnant, non-breastfeeding women:

Replace

Benzathine Penicillin with doxycycline, oral 100 mg 12 hourly for 14 days

Erythromycin with ciprofloxacin, oral 500 mg, 12 hourly for 3 days

Pregnant, breastfeeding women:

Replace

Benzathine Penicillin with erythromycin, oral 500 mg, 6 hourly for 14 days