PHD RECOMMENDED STD TREATMENTS – February 2011
ALTERNATIVE REGIMEN: to be
DISEASE/ PATHOGEN
RECOMMENDED REGIMEN
used if medical contraindications or
intolerance to recommended regimen
Chlamydia
Uncomplicated genital/
rectal/ pharyngeal
infections
 Azithromycin 1 gram po as a single dose
 Doxycycline 100 mg po BID x 7
days
 Levofloxacin 500 mg po QD x 7
days
Pregnant women
 Azithromycin 1 gram po as a single dose
 Amoxicillin 500 mg po TID x 7 days
Gonorrhea. Ceftriaxone PLUS Azithromycin is the preferred treatment for patients with uncomplicated
gonorrhea infections.
Uncomplicated genital/
Rectal infections
Ceftriaxone 250 mg IM in a single dose
PLUS Azithromycin 1 gram po as a single
dose
Pharyngeal infections
Ceftriaxone 250 mg IM as a single dose
PLUS Azithromycin 1 gram po as a single
dose
Penicillin or
cephalosporin allergic
patient
Consult a clinician (Azithromycin 2 grams
orally as a single dose is an option in
limited circumstances)
Cefixime 400 mg po as single dose
PLUS Azithromycin 1 gram po as a
single dose
**Oral therapy is NOT recommended
for pharyngeal infections. Consult
clinician if unable to give
ceftriaxone**
__
Non-gonococcal urethritis
Men
Azithromycin 1 gram po as a single dose
 Doxycycline 100 mg po BID x 7
days
 Levofloxacin 500 mg po QD x 7
days
For treatment failure or
recurrence
Metronidazole 2 g po as a single dose and
possible retreatment with azithromycin 1
gram po as a single dose
See NGU section for additional
details
Epididymitis
Likely due to gonorrhea
or chlamydia
Ceftriaxone 250 mg IM in a single dose
PLUS doxycycline 100 mg po BID x 10
days
Likely due to enteric
organisms
Levofloxacin 500 mg po QD x 10 days
Pelvic Inflammatory Disease
IM/Oral
Ceftriaxone 250 mg IM in a single dose
PLUS doxycycline 100 mg po BID x 14
days
PLUS metronidazole 500 mg po BID x14
days if BV is present or anaerobes
suspected
Patients requiring parenteral therapy
should be referred
Metronidazole 2 grams po as a single dose
Metronidazole 500 mg po BID x 7
days
Trichomoniasis
Men and women
Bacterial Vaginosis
Women
Metronidazole 500 mg po BID x 7 days
NMDOH/PHD/STD Protocol
January 2011
Attachment E
PHD HEPATITIS TESTING AND IMMUNIZATION RECOMMENDATIONS – June 2010
TESTING Recommended
RISK GROUP
IMMUNIZATION
Recommended
HBIG
Recommended
HEP A
HEP B*
HEP C**
HEP A
HEP B
Current IDU
No
Yes
Yes
Yes
Yes
No
Persons who share crack/meth
pipes or intranasal inhalant
equipment such as straws
No
Yes
Yes
Yes
Yes
No
Former IDU
No
Yes
Yes
No
No
No
MSM or Bisexual male
No
Yes
No
Yes
Yes
No
Sexual Contact of MSM or IDU
No
No
No
Yes
Yes
No
Hepatitis C Positive
No
Yes
--
Yes
Yes
No
Hepatitis B Acute/Chronic
Carrier
No
--
Yes
Yes
--
No
HIV Positive
No
Yes
Yes
Yes
Yes
No
No
No
Yes
No
No
No
No
Yes
No
No
Yes
No
No
No
No
No
Yes
No
No
No
No
No
Yes
No
Blood transfusion or organ
transplant before July 1992
Person from endemic area incl.
Asia, Central and Eastern
Europe, Sub-Saharan Africa
Heterosexual with multiple sex
partners (>1 in last 6 months)
Persons seeking evaluation or
treatment for an STD
CONTACTS – HEPATITIS B ACUTE CASES
Sexual contact of acute case of
hepatitis B within last 14 days4
Household contact of acute
case, no known exposure6
Household contact of acute
case, known exposure (e.g.
shared toothbrush or razor)
Injection partner contact within
last 14 days
No
Yes
No
No
Yes
Yes
No
No
No
No
Yes
No
No
Yes
No
No
Yes
Yes
No
Yes
Yes
Yes
Yes
Yes
CONTACTS – HEPATITIS B CHRONIC CASES
Sexual contact of chronic case
of hepatitis B
Household contact of chronic
case of hepatitis B
Injection partner contact
No
Yes
No
No
Yes
No
No
Yes
No
No
Yes
No
No
Yes
Yes
Yes
Yes
Yes
CONTACTS – HEPATITIS C CASES (CHRONIC OR ACUTE) Follow Risk Group recommendations above
* Testing should include hepatitis B surface antigen (HBSAg), hepatitis B total core antibody (HBcAb),
and hepatitis B surface antibody (HBSAb)
** Testing should include a hepatitis C antibody (HCV Ab)
NMDOH/PHD/STD Protocol
February 2011
Attachment E
PHD GC/ CT Screening Protocol Flowchart
High Risk Population or Venue?




MSM
HIV Infected
Transgender
Incarcerated or entering correctional
setting
 Exchanges sex for drugs/ money
 Had STD in past year
 Contact to known STD
OK to Screen
Pregnant?
OK to Screen
OR
Seeking IUD Insertion?
 Screen all females annually
 OK to offer screening to males
seeking STD services
Age ≤ 25 years?
Age 26-29 years?
AND at least one of the following:
YES
OK to Screen
NO
Refer patient for private sector
testing at patient’s expense
 Client or partner with ≥ 2 partners
in past year
 New sex partner in past 3 months
 STD in past year
Age ≥ 30 years?
Refer patient for private sector
testing at patient’s expense
UNLESS in high risk group or venue;
pregnant; or seeking IUD insertion as
detailed above
NMDOH/PHD STD Protocol
February 2011
Attachment E