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new STD guidelinesFrom: Robert J. Woolley (wooll005@gold.tc.umn.edu)Sun Jun 1 18:22:10 1997
I spent the week in New Orleans at the American College Health Association meeting. One of the speakers was a gentleman from the CDC (whose name is buried in a suitcase somewhere), who discussed the forthcoming (late this year) STD treatment guidelines. They had their meeting in January, and have already been through several drafts. He expects no substantial changes between now and publication. The most significant change was for outpatient management of PID. In addition to an injectable 3rd=generation cephalosporin and doxycycline, they will recommend adding a third agent, metronidazole, 500mg tid for a week (as I recall). The reasoning (discussed only briefly) was to broaden the anaerobic coverage. I wonder about the wisdom of this. If it increases the side effects (as it surely will), might it not result in substantially more incompletely treated cases? Second, doxycycline has reasonbly decent anaerobic coverage as it is; does metronidazole really add enough additional coverage to be justified? Third, why not substitute clindamycin for the doxy/metro combination to simplify the regimen? (Cost? Side effects? QID dosing?) Thoughts? ---------------------------------------------------------------------------
--------------------------------------------------------------------------- Bob Woolley -- --------------------------------------------------------------------------- St. Paul, Minnesota
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