COLUMBUS COUNTY HEALTH DEPARTMENTS
CHANCROID POLICY
Policy Title:
Chancroid
Program Area:
STD Clinic
Policy Identifier:
(optional)
Effective Date:
Approval Date:
Revision
Date(s):
Unknown
5/29/2013
Approved by:
Kim Smith RN, BSN, MSHCA, Health Director
Approved by:
Hilda Memory RN, BS, MSHA, Director of Nursing
Purpose:
will assess, treat and or refer patients to physicians or midlevel
practitioners in an effort to decrease the number of STDs in Columbus and
surrounding counties.
STD ERRN
Definitions:
STD ERRN will assess, test and treat per standing orders and or will refer to a
midlevel practitioner or physician as needed.
Responsibilities:
STD ERRNs, Mid-level practitioners, and Supervisors
Procedures:
Chancroid
A. Endemic in many areas of the U.S. Co-factor for HIV transmission and a high
rate of HIV infection among patients with Chancroid has been reported.
Caused by Haemophilus ducrey:
B. Clinical manifestations:
1. Painful, nonintegrated ulcerations with irregular, undermined borders.
2. Unilateral or bilateral tender adenopathy occurs in approximately half
the patients.
Medically Indicated:
A. If the patient has one or more painful genital ulcers.
B. The clinical presentation of the ulcer(s) is not typical of disease caused by
HSV or the HSV test results are negative.
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COLUMBUS COUNTY HEALTH DEPARTMENTS
CHANCROID POLICY
Treatment:
A. Azithromycin 1 gm p.o. x one dose.
Adverse Reactions:
A. Azithromycin- Most frequent oral dose related, include abdominal cramping
and discomfort, anorexia, nausea, vomiting, and diarrhea. Mild reactions
include rashes with or without pruritis, and urticaria.
Contraindication:
A. Allergy to Azithromycin
 Refer to mid-level practitioner, physician
Physician Referral:
If one of the following is present refer to mid-level practitioner, physician or ED.
A. Cases where painful fluctuant lymph nodes which may require aspiration of
the nodes to provide quicker healing and alleviate pain.
B. When no clinical improvement is evident by 7 days after therapy.
Follow-Up:
If symptoms persist following therapy refer to mid-level practitioner or physician for
evaluation.
Patient Instruction:
A. Explain how to take their oral medications.
B. Return weekly for evaluation until the infection is entirely healed.
C. Advise patient to notify sex partner(s) of need for examination and
treatment, Sex partners, within 10 days preceding onset of symptoms in
an infected patient, whether symptomatic or not, should be examined
and treated with recommended regimen.
D. Avoid sex until patient and partner(s) are cured.
E. Use condoms to prevent future infections.
F. Explain that Chancroid has been associated with an increased risk of
acquiring HIV infection. Patients diagnosed with Chancroid should
be strongly encouraged to be HIV tested.
G. Caution female patients who take oral contraceptives
to use a back-up method of birth control while on antibiotic
therapy and for seven days after completion
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COLUMBUS COUNTY HEALTH DEPARTMENTS
CHANCROID POLICY
Control Click for Standing Order
Chancroid
Laws and Rules:
10A NCAC 41A.0202, 10A NCAC 41A.0204, 10A NCAC 41A.0102
Reference(s):
NC Sexually Transmitted Disease Public Health Program Manual
The Pocket Reference Guide for Clinical Evaluation and Treatment of Clients with
Sexually Transmitted Infections.
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