AIIMS Antibiotics guidance on Sexually Transmitted Infections

All India Institute of Medical Sciences, Delhi has released AIIMS Antibiotics Policy which has been prepared by the Department of Medicine with Multidisciplinary collaboration. The guidance for Sexually Transmitted Infections is hereunder.

Sexually Transmitted Infections :

Urethral discharge (Chlamydia/Gonorrhoea/ Mycoplasma/trichomonas)Preferred (NACO): Kit 1/ GreyTab. Azithromycin 1 gm OD Stat + Tab. Cefixime 400 mg OD Stat

Alternative: Ceftriaxone 250 mg IM stat (in place of cefixime)

Cervical discharge:

Preferred (NACO): Kit 1/ GreyTab. Azithromycin 1 gm OD Stat + Tab. Cefixime 400 mg OD Stat

Alternative: Ceftriaxone 250 mg IM stat (in place of cefixime)

Painful scrotal swelling:

Preferred (NACO): Kit 1/ GreyTab. Azithromycin 1 gm OD Stat + Tab. Cefixime 400 mg OD Stat

Alternative: Ceftriaxone 250 mg IM stat (in place of cefixime)

Vaginal Discharge:

Preferred (NACO): Kit 2/ GreenTab. Secnidazole 2 g OD Stat + Cap. Fluconazole 150 mg OD Stat

Alternative: Secnidazole can be replaced with Tinidazole 2g single dose

Genital ulcer- non-herpetic (chancre/chancroid)Single or multiple, painful or painless/ Burning sensation in the genital area/ Enlarged lymph nodes.

Treatment: Kit 3/ white Inj. Benzathine penicillin (2.4 MU) - 1 vial + Tab. Azithromycin (1 gm) - Single-dose Or Kit 4/Blue- allergic to penicillins

Doxycycline 100 mg (Bid for 15 days) + Azithromycin 1g (Single dose)

Genital ulcer herpetic: Ulcer or vesicles, single or multiple, painful, recurrent n Burning sensation in the genital area

Preferred: Kit 5/RedTab. Acyclovir 400 mg TDS for 7 days

Alternative: Valacyclovir 1,000 mg orally twice daily or Famciclovir 250 mg TDS for 7 days

Lower abdominal pain Lower Abdominal Pain/Fever/ Vaginal Discharge/ Menstrual irregularities/dyspareunia, dysuria, tenesmus/ Lower backache/ Cervical motion tenderness

Treatment: Kit 6/YellowTab. Cefixime 400 mg OD stat + Tab. Metronidazole 400 mg BD X 14 days + Doxycycline 100 mg BD X 14 days

Inguinal bubo (LGV/chancroid)Swelling in an inguinal region which may be painful/ Preceding history of genital ulcer or discharge/ Systemic symptoms like malaise, fever etc

Preferred: Kit 7/BlackTab. Azithromycin 1 gm OD Stat + Tab. Doxycycline 100 mg BD for 21 days

Alternative: Tab Azithromycin 1 gm weekly for three weeks