CDC updates STD treatment guidelines

The Centers for Disease Control and Prevention (CDC) has issued new guidelines for treating sexually transmitted diseases (STDs). The guidelines update the CDC’s 2006 recommendations.

Sexually Transmitted Diseases Treatment Guidelines, 2010, published in the Morbidity and Mortality Weekly Report (2010;59[RR-12]:1-109), offers new information on the most effective treatment, screening, and preventive strategies for STDs and vaccination schedules for vaccine-preventable infections.

The recommendations were developed through consultation with a group of experts who convened in Atlanta in April. The authors emphasize that the guidelines are meant to provide clinical guidance rather than “prescriptive standards.”

The new guidelines recommend a 5-prong strategy for preventing STDs: educating and counseling people at risk; diagnosing asymptomatic infections and symptomatic infections in people who are unlikely to access diagnostic and management services; accurately diagnosing and effectively treating and counseling infected people; evaluating, treating, and counseling partners of infected people; and vaccinating people at risk of vaccine-preventable STDs before exposure.

The guidelines also include new information on expanded diagnostic evaluation of cervicitis and trichomoniasis; treatment of bacterial vaginosis and genital warts; clinical efficacy of azithromycin for chlamydial infections in pregnant women; the role of Mycoplasma genitalium and trichomoniasis in urethritis-cervicitis and treatment recommendations; lymphogranuloma venereum proctocolitis among men who have sex with men; criteria for examining spinal fluid for neurosyphilis; emergence of azithromycin-resistant Treponema pallidum; increasing prevalence of drug-resistant Neisseria gonorrhoeae; sexual transmission of hepatitis C; and diagnostic evaluation after sexual assault.