uteritis

Genital Ulcer Management

• Syphilis (Primary & Secondary)

  • First-line: Benzathine-benzylpenicillin $2.4\,\text{million IU}$, single intramuscular (IM) dose.
  • If allergic to penicillin and NOT pregnant:
  • Procaine-penicillin $600\,000\,\text{U} / \text{day}$ IM for $10$ days.
  • OR Doxycycline $2\times100\,\text{mg/day}$ per oral (PO) for $30$ days.
  • OR Erythromycin $4\times500\,\text{mg/day}$ PO for $30$ days.
  • OR Ceftriaxone $250\,\text{mg}$ IM, single dose.
  • Doxycycline is contraindicated in pregnancy, lactation, and children <$12$ years.

• Chancroid (Soft Chancre / Ulkus Mole)

  • Ciprofloxacin $2\times500\,\text{mg/day}$ PO for $3$ days.
  • OR Erythromycin base $4\times500\,\text{mg/day}$ PO for $7$ days.
  • OR Azithromycin $1\,\text{g}$ PO, single dose.
  • Ciprofloxacin is contraindicated in pregnancy, lactation, and children <$12$ years.

• Herpes Genitalis – First Episode

  • Acyclovir $5\times200\,\text{mg/day}$ PO for $7$ days.
  • OR Acyclovir $3\times400\,\text{mg/day}$ PO for $7$ days.
  • OR Valacyclovir $2\times500\,\text{mg/day}$ PO for $7$ days.

• Herpes Genitalis – Recurrence

  • Acyclovir $5\times200\,\text{mg/day}$ PO for $5$ days.
  • OR Acyclovir $3\times400\,\text{mg/day}$ PO for $5$ days.
  • OR Valacyclovir $2\times500\,\text{mg/day}$ PO for $5$ days.

• Lymphogranuloma Venereum (LGV)

  • Doxycycline $2\times100\,\text{mg/day}$ PO for $14$ days.
  • OR Erythromycin base $4\times500\,\text{mg/day}$ PO for $14$ days.

Urethral Discharge (Urethritis)

Gonococcal Urethritis (GU)

• Cefixime $400\,\text{mg}$ PO, single dose.
• OR Levofloxacin $500\,\text{mg}$ PO, single dose.

Non-Gonococcal Urethritis (NGU)

• Azithromycin $1\,\text{g}$ PO, single dose.
• OR Doxycycline $2\times100\,\text{mg/day}$ PO for $7$ days.

Alternative / Second-Line Options (for GU & NGU)

• Kanamycin $2\,\text{g}$ IM, single dose.
• OR Erythromycin $4\times500\,\text{mg/day}$ PO for $7$ days.
• OR Thiamphenicol $3.5\,\text{g}$ PO, single dose.
• OR Ceftriaxone $250\,\text{mg}$ IM, single dose.

Levofloxacin and Doxycycline are contraindicated in children <$12$ years.

Vaginal Discharge Due to Cervicitis

Gonococcal Cervicitis

• Cefixime $400\,\text{mg}$ PO, single dose.
• OR Levofloxacin $500\,\text{mg}$ PO, single dose.

Non-Gonococcal Cervicitis

• Azithromycin $1\,\text{g}$ PO, single dose.
• OR Doxycycline $2\times100\,\text{mg/day}$ PO for $7$ days.

Alternative / Second-Line Options

• Kanamycin $2\,\text{g}$ IM, single dose.
• OR Thiamphenicol $3.5\,\text{g}$ PO, single dose.
• OR Ceftriaxone $250\,\text{mg}$ IM, single dose.
• OR Erythromycin $4\times500\,\text{mg/day}$ PO for $7$ days.

Levofloxacin and Doxycycline are contraindicated in pregnancy, lactation, or children <$12$ years.

Vaginal Discharge Due to Vaginitis

Trichomoniasis

• Metronidazole $2\,\text{g}$ PO, single dose.
• Alternative: Metronidazole $2\times500\,\text{mg/day}$ PO for $7$ days.

Bacterial Vaginosis

• Metronidazole $2\,\text{g}$ PO, single dose.
• OR Metronidazole $2\times500\,\text{mg/day}$ PO for $7$ days.
• OR Clindamycin $2\times300\,\text{mg/day}$ PO for $7$ days.

Candidiasis Vaginitis

• Miconazole or Clotrimazole $200\,\text{mg}$ intravaginally, daily for $3$ days.
• OR Clotrimazole $500\,\text{mg}$ intravaginally, single dose.
• OR Fluconazole $150\,\text{mg}$