Treatment
Patients (and their partners) should be advised to abstain from sexual contact for seven days from the day the treatment was started and until the symptoms resolve. If this time period is not respected, condoms should always be used.
All persons who receive a diagnosis of an STI should be tested for other STIs, including chlamydia, gonorrhoea, syphilis, and HIV.
Patients (and their sex partners) should be given information about their infection, including details about transmission, prevention and complications. Oral information needs to be reinforced with written support or video material (see tab "Useful links" for some examples).
Some STIs must be notified. This obligation varies by region. For more information, click HERE
Man / non-pregnant woman / adolescent
- Ceftriaxone 1g IM in a single dose
Pregnant woman
- Ceftriaxone 1g IM in a single dose
Person with allergy to penicillin / cephalosporins
- Refer to secondary care for choice of adequate treatment.
Man / non-pregnant woman / adolescent
Uncomplicated urogenital, rectal or oropharyngeal infection:
Anorectal LGV infection:
Pregnant or breastfeeding woman
- Azithromycin 1g, orally in a single dose
Man / non-pregnant woman / adolescent
Uncomplicated Gonorrhoea / Chlamydia co-infection:
- Ceftriaxone 1g IM in a single dose
- AND doxycyclin 100mg twice a day orally for 7 days
Gonorrhoea / LGV co-infection:
- Ceftriaxone 1g IM in a single dose
- AND doxycycline 100mg twice a day orally for 21 days
Pregnant woman
Uncomplicated Gonorrhoea / Chlamydia co-infection:
- Ceftriaxone 1g IM in a single dose
- AND azithromycin 1g orally in a single dose
Gonorrhoea / LGV co-infection:
- Refer to secondary care for choice of most adequate treatment.
Person with allergy to penicillin / cephalosporins
- Refer to secondary care for choice of most adequate treatment.
Man / non-pregnant woman / adolescent
Early syphilis (primary, secondary and early latent up to 1 year), including in persons with HIV:
- First choice: BPG 2.4 million units IM in two injections on the same day
- Second choice: Doxycycline 100 mg orally twice a day for 14 days (be aware of photosensitisation)
Late syphilis (> 1 year), including in persons with HIV:
- First choice: BPG 2.4 million units IM weekly for 3 consecutive weeks (day 1, day 8 and day 15)
- Second choice: Doxycycline 100 mg orally twice a day for 28 days (be aware of photosensitisation)
Pregnant woman
- Refer to secondary care for treatment and follow-up
In case of penicillin allergy
- When in doubt, first assess the risk of anaphylaxis. If patients have a history compatible with an IgE mediated allergy then alternative therapies (such as doxycycline) should be used.
- Patients should also be referred for skin testing to confirm allergy and for consideration of penicillin desensitisation.
Refer to secondary care as soon as possible
Hepatitis A and/or B: in case of a negative test, perform a vaccination.
Acute infection: referral to secondary care if liver tests are abnormal.
Chronic hepatitis B and C infections: always refer to secondary care even when liver tests are normal.