FIGURE 1. URETHRAL DISCHARGE

Treatment of Urethral Discharge GonorrheaChlamydia Ciprofloxacin 500mg orally x 1 doseAzithromycin 1g orally x 1 dose Cefixime 400mg orally x 1 doseDoxycycline 100mg orally twice daily x 7 days Ceftriaxone 250mg IM x 1 doseAmoxicillin 500mg orally three times daily x 7 days Spectinomycin 2g IM x 1 doseErythromycin 400mg orally four time daily x 7 days Ofloxacin 300mg orally twice daily x 7days Tetracycline 500mg orally four times daily x 7 days *Fluoroquinolones and tetracyclines are contraindicated in pregnancy

FIGURE 2. PERSISTENT/RECURRENT URETHRAL DISCHARGE IN MEN

Trichomonas Vaginalis Treatment: – Metronidazole 500mg orally twice daily x 7 days, OR – Tinidazole 500mg orally twice daily x 5 days

1 Indications for syphilis treatment: - RPR positive; and - Patient has not been treated for syphilis recently. 2 Treat for HSV2 where prevalence is 30% or higher, or adapt to local conditions. FIGURE 3. GENITAL ULCERS

Treatment of Genital Ulcers HerpesSyphilisChancroid First Episode: Acyclovir 400mg orally three times daily x 7 days Benzathine benzylpenicillin 2.4 MU IM x 1 dose Azithromycin 1g orally x 1 dose Valacyclovir 1g orally twice daily x 7 days Procaine benzylpenicillin 1.2 MU IM daily x 10 doses Ceftriaxone 250mg IM x 1 dose Recurrent episode: Acyclovir 400mg orally three times daily x 5 days Doxycycline 100mg orally twice daily x 15 days Ciprofloxacin 500mg twice daily x 3 days Valacyclovir 1g orally once daily x 5 days Erythromycin base 500mg orally four times daily x 7 days

FIGURE 5. SCROTAL SWELLING

Treatment of Scrotal Swelling GonorrheaChlamydia Ciprofloxacin 500mg orally x 1 doseAzithromycin 1g orally x 1 dose Cefixime 400mg orally x 1 doseDoxycycline 100mg orally twice daily x 7 days Ceftriaxone 250mg IM x 1 doseAmoxicillin 500mg orally three times daily x 7 days Spectinomycin 2g IM x 1 doseErythromycin 400mg orally four time daily x 7 days Ofloxacin 300mg orally twice daily x 7days Tetracycline 500mg orally four times daily x 7 days *Fluoroquinolones and tetracyclines are contraindicated in pregnancy

FIGURE 4. INGUINAL BUBO

Treatment of Inguinal Bubo Treat for both Chancroid and LGV – Ciprofloxacin 500mg orally twice daily x 3 days AND – Doxycycline 100mg orally twice daily x 7 days

FIGURE 6. VAGINAL DISCHARGE

Treatment of Vaginal Discharge GonorrheaChlamydia Ciprofloxacin 500mg orally x 1 doseAzithromycin 1g orally x 1 dose Cefixime 400mg orally x 1 doseDoxycycline 100mg orally twice daily x 7 days Ceftriaxone 250mg IM x 1 doseAmoxicillin 500mg orally three times daily x 7 days Spectinomycin 2g IM x 1 doseErythromycin 400mg orally four time daily x 7 days Ofloxacin 300mg orally twice daily x 7days Tetracycline 500mg orally four times daily x 7 days *Fluoroquinolones and tetracyclines are contraindicated in pregnancy

Bacterial Vaginosis Treatment: – Metronidazole 2g orally x 1 dose OR – Metronidazole 500mg orally twice daily x 7 days OR – Clindamycin 300mg orally twice daily x 7 days OR – Clindamycin or metronidazole gels vaginally

Candida Treatment: – Clotrimazole 500mg vaginally x 1 dose OR – Fluconazole 150mg orally x 1 dose

FIGURE 9. LOWER ABDOMINAL PAIN

Treatment of Pelvic Inflammatory Disease Treat for gonorrhea, chlamydia and anaerobes – Ceftriaxone 250mg IM x 1 dose AND – Doxycycline 100mg orally twice daily x 14 days AND – Metronidazole 500mg orally twice daily x 14 days Review patient in 3 days if treating as outpatient, if no improvement refer

FIGURE 10. NEONATAL CONJUNCTIVITIS

Treatment of Conjunctivitis in Infants Treat for Gonorrhea and Chlamydia – Ceftriaxone 50mg/kg (max 125mg) IM injection x 1 dose AND – Erythromycin syrup 50mg/kg/day orally, in 4 divided dose x 14 days OR – Trimethoprim 40mg/Sulfamethoxazole 200mg orally twice daily x 14 days