Medical Pharmacology Chapter 35  Antibacterial Drugs
 

Previous Page

Sexually Transmitted Diseases:  Drug Treatment
  • Epididymitis

    • Affected age group: < 35 years old

    • Older age group or those who have had urinary tract instrumentation:

      • Causative agents:

        • Enteric gram-negative bacilli

          • May also cause urethritis or epididymitis in men practicing unprotected, inserted anal intercourse

        • Pseudomonas

    • Drug of choice:

      • Ofloxacin (Floxin)

        •  May be used in the absence of culture data

    • Alternative agent:

      • Ceftriaxone (Rocephin) (single IM dose followed by 10 day treatment with doxycycline (Vibramycin, Doryx)

  • Pelvic Inflammatory Disease

    • Causative Agents

      • Chlamydia trachomatis and Neisseria gonorrhoeae: responsible for about 2/3 of active cases

      • Other organisms included Mycoplasma hominis (other facultative agents and anaerobic bacteria can be present)

    • Inpatients:

      • Drugs of choice:

        •  Cefotetan (Cefotan) or cefoxitin (Mefoxin) plus doxycycline (Vibramycin, Doryx, contraindicated in pregnancy)

        •  Doxycycline (Vibramycin, Doryx) alone -- contraindicated in pregnancy

        • Or

        • Clindamycin (Cleocin) +gentamicin (Garamycin), followed by doxycycline (Vibramycin, Doryx)

      •  Alternative agents:

        • Ofloxacin (Floxin) + metronidazole (Flagyl)

        • Ampicillin (Principen, Omnipen)/sulbactam + doxycycline (Vibramycin, Doryx)

        • Ciprofloxacin + doxycycline (Vibramycin, Doryx,contraindicated in pregnancy) + metronidazole (Flagyl)

        • All combinations continued until improvement is observed: then doxycycline (Vibramycin, Doryx, contradicted in pregnancy) for a 14 day time course

    • Outpatients

      • Drugs of choice:

        • Ofloxacin (Floxin, contraindicated in pregnancy) + metronidazole (Flagyl)

        • Or

        • Ceftriaxone (Rocephin) Or

        • Cefoxitin (Mefoxin) + probenecid (Benemid)-- either cephalosporin, ceftriaxone (Rocephin) or cefoxitin (Mefoxin), followed by doxycycline (Vibramycin, Doryx, contraindicated in pregnancy)

         

        Reference:"Drugs for Sexually Transmitted Infections", The Medical Letter, vol. 41 (issue 1063), September, 24, 1999, Published by the Medical Letter, Inc, New Rochelle, N.Y.

Previous Page

This Web-based pharmacology and disease-based integrated teaching site is based on reference materials, that are believed reliable and consistent with standards accepted at the time of development. Possibility of human error and on-going research and development in medical sciences do not allow assurance that the information contained herein is in every respect accurate or complete. Users should confirm the information contained herein with other sources. This site should only be considered as a teaching aid for undergraduate and graduate biomedical education and is intended only as a teaching site. Information contained here should not be used for patient management and should not be used as a substitute for consultation with practicing medical professionals. Users of this website should check the product information sheet included in the package of any drug they plan to administer to be certain that the information contained in this site is accurate and that changes have not been made in the recommended dose or in the contraindications for administration.  Advertisements that appear on this site are not reviewed for content accuracy and it is the responsibility of users of this website to make individual assessments concerning this information.  Medical or other information  thus obtained should not be used as a substitute for consultation with practicing medical or scientific or other professionals.