Management of Mixed Infections - Table 12.1
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Mixed Sexually Transmitted Infections |
Drug Treatment (new episode) |
UDS + SSS |
Ceftriaxone (IM) 250mg stat AND Azithromycin (PO) 1g per week for 2weeks AND Metronidazole (PO) 2g stat AND Supportive therapy: to reduce pain advise bed rest, scrotal elevation with a scrotal support (T- bandage) and analgesics. |
UDS + Balanitis |
Cefixime (PO) 400mg stat OR Ceftriaxone (IM) 250mg stat AND Azithromycin (PO) 1g stat OR Doxycycline (PO) 100mg 12hourly for 7days AND Metronidazole (PO) 2g stat AND Clotrimazole cream, local application 12hourly for 7days |
UDS + GUS |
Cefixime (PO) 400mg stat OR Ceftriaxone (IM) 250mg stat AND Acyclovir (PO) 400mg 8hourly for 7days AND Benzathine Penicillin* (IM) 2.4MU stat AND Azithromycin (PO) 1g stat OR Doxycycline* (PO) 100mg 12hourly for 7days AND Metronidazole (PO) 2g stat |
VDS + LAP |
Ceftriaxone (IM) 250mg stat AND Azithromycin (PO) 1g per week for 2weeks AND Metronidazole (PO) 400mg 12hourly for 7–14days. Clotrimazole pessary to be added, if vulva oedema, itching, excoriations or curd-like discharge present |
VDS + GUS (non- pregnant) |
Cefixime 400mg stat OR Ceftriaxone (IM) 250mg stat AND Metronidazole (PO) 2g stat AND Benzathine Penicillin* (IM) 2.4 MU stat AND Azithromycin (PO) 1g stat OR Doxycycline* (PO) 100mg 12hourly for 7days AND Acyclovir (PO) 400mg 8 hourly for 7 days. Clotrimazole pessary to be added, if vulva oedema, itching, excoriations or curd-like |
VDS + GUS |
Cefixime 400mg stat OR Ceftriaxone (IM) 250mg stat AND Metronidazole (PO) 2g stat AND Benzathine Penicillin* (IM) 2.4 MU stat AND Azithromycin (PO) 1g stat OR Erythromycin* (PO) 500mg 6hourly for 7days AND Acyclovir (PO) 400mg 8hourly for 7days. Clotrimazole pessary to be added, if vulva oedema, itching, excoriations or curd-like discharge present |
LAP + GUS |
Ceftriaxone (IM) 250mg stat AND Metronidazole (PO) 400 mg 12hourly for 7–14days AND Benzathine Penicillin* (IM) 2.4MU stat AND Azithromycin (PO) 1g per week for 2weeks OR Doxycycline* (PO) 100 mg 12hourly for 7–14days AND Acyclovir (PO) 400 mg 8hourly for 7days |
SSS + GUS |
Ceftriaxone (IM) 250mg stat AND Benzathine Penicillin* (IM) 2.4MU stat AND Azithromycin (PO) 1g per week for 2weeks OR Doxycycline* (PO) 100mg 12hourly for 7–14days AND Acyclovir (PO) 400mg 8hourly for 7days |
Note: In Penicillin-allergic patients: Give Doxycycline (non-pregnant women/men) or Erythromycin (pregnant women) for 14days instead of 7days |