Treatment Recommendations for Selected STDs in Pregnancy

Rekomendasi Penatalaksanaan Penyakit Menular Seksual pada Kehamilan

Disease Treatment Regimen Bacterial vaginosis Metronidazole, 500 mg PO twice daily for 7 d   or  Clindamycin, 300 mg PO twice daily for 7 d   or  Metronidazole, 250 mg PO 3 times daily for 7 d Chancroid Azithromycin, 1 g PO in a single dose   or  Ceftriaxone, 250 mg IM in a single dose   or  Erythromycin base, 500 mg PO 3 times daily for 7 d Chlamydiaa Azithromycin, 1 g PO in a single dose   or  Amoxicillin, 500 mg PO 3 times daily for 7 d Cytomegalovirus Supportive care Genital herpes Acyclovir, 400 mg PO 3 times daily for 7–14 d (first episode) Acyclovir, 400 mg PO 3 times daily for 5 d (recurrent episode) Acyclovir, 400 mg PO 3 times daily (suppression after 36 wk) Alternative regimen (for women in whom adherence is an issue): valacyclovir, 500 mg daily Genital warts Cryotherapy and trichloroacetic acid Gonorrheab Cefpodoxime, 400 mg PO in a single dose   or  Ceftriaxone, 125 mg IM in a single dose Alternate regimen (for women who cannot tolerate a cephalosporin: spectinomycin, 2 g IM as a single dose Granuloma inguinale Erythromycin base, 500 mg PO 4 times daily for at least 3 wk ± parenteral aminoglycoside Hepatitis A Immunoprophylaxis (immune serum globulin and hepatitis A vaccine) as needed Hepatitis B Immunoprophylaxis (HBIG and hepatitis B vaccine) as needed Lymphogranuloma venereum Erythromycin base, 500 mg PO 4 times daily for 21 d Molluscum contagiosum Curettage, cryotherapy, chemical cauterization, or laser therapies Pediculosis pubis Permethrin 1% cream rinse to affected areas, washed off after 10 min   or  Pyrethrins with piperonyl butoxide to affected area, washed off after 10 min Scabies Permethrin cream (5%) to all areas of body from neck down, washed off after 8–14 h Syphilisc Benzathine penicillin G, 2.4 million units IM in a single dose (primary, secondary, early latent) Benzathine penicillin G, 7.2 million units total, 2.4 million units IM once weekly for 3 weeks (late latent or latent of unknown duration) Trichomoniasis Metronidazole, 2 g PO in a single dose

aRepeat test 3 wk after completion of therapy. bIf chlamydia infection has not been excluded, then treat for presumptive co-infection. cMay consider second dose of benzathine penicillin 2.4 million units IM 1 week after initial dose for women who have primary, secondary, or early latent syphilis.

Referensi: Current Diagnosis and Treatment Sexually Transmitted Diseases (McGraw-Hill) 2007

Tags: Lecture Notes