Diagnosis and Treatment of Sexually Transmitted Infections in Urgent Care (Pharmacology CME and Infectious Disease CME)

Points & Pearls Excerpt

• The CDC estimates that there are 26.2 million new sexually transmitted infection (STI) diagnoses each year, which presents not only a massive public health challenge, but represents $16 billion in direct costs to the healthcare system.
• Patients can present with multiple concurrent STIs. Avoid premature diagnostic closure and consider multiple simultaneous processes.
• Urinary tract infections (UTIs) and STIs can present similarly, though UTIs are arguably less common in males than females due to a comparatively longer urethra. Point-of-care testing and a urogenital/pelvic examination may be indicated to avoid misdiagnosis.
• Chlamydia is the most common bacterial STI. The diagnostic test of choice is nucleic acid amplification testing (NAAT). Treat with doxycycline, but azithromycin could be used if necessary. Table 7 reviews the medications and dosages for this and other common STIs.