Antibiotics for Bacterial STDs

When treating sexually transmitted infections (STIs), antibiotics are usually the go-to treatment. Bacterial STIs, like syphilis, gonorrhea, and chlamydia, can only be treated with antibiotics. But it's not a one-size-fits-all approach. Different antibiotics are used in varying doses and durations to combat these infections.

Also, some bacterial STIs are developing resistance to typical antibiotics, making some of these infections more difficult to treat.

But there's a twist in the tale. Some strains of gonorrhea, like H041 and F89, are proving resistant to common antibiotics like ceftriaxone and cefixime. In fact, in 2011, 63% of gonococcal isolates showed reduced susceptibility to cefixime. So, what's the alternative? For those who can't receive intramuscular injections, or have a penicillin allergy, other antibiotics like ciprofloxacin or ofloxacin might be the answer.

• with common strains of gonorrhea showing resistance to common antibiotics like ceftriaxone and cefixime. In such cases, alternative antibiotics like ciprofloxacin or ofloxacin might be employed.

Treatment of STIs

Different types of STIs are treated with different classes of medications. Bacterial STIs like chlamydia, gonorrhea, and syphilis are typically treated with a course of antibiotics. Parasitic STIs such as trichomoniasis are also treated with antibiotics. On the other hand, viral STIs such as herpes and HIV are treated with antiviral medications. These antiviral medications don’t cure the disease but they can reduce symptoms and help them go dormant or inactive.

Untreated STIs pose serious health risks, from pelvic inflammatory disease, ectopic pregnancy, and miscarriage in women to infertility in both sexes. Plus, untreated chlamydia, gonorrhea, and syphilis can double or triple your risk of getting HIV.

Stopping the transmission of STIs and preventing reinfection are important strategies in STI management. It’s important to make sure any partners you’ve had are also tested and if they test positive, also treated.

Antibiotic use in sexually transmissible diseases

During treatment, it's important to stick to the regimen prescribed by your healthcare professional to avoid the rise of antibiotic-resistant strains. These are becoming a serious public health concern, especially when dealing with gonorrhea. Adhering strictly to your treatment plan can help prevent antibiotic resistance.

Antibiotics for bacterial vaginosis (BV)

Bacterial vaginosis (BV), while not as notorious as other STIs such as chlamydia or syphilis, has a significant impact on sexual health. It's among the conditions that are curable with antibiotics. You might not hear about it as often, but it's essential to recognize the symptoms if they arise. It can be mistaken for a yeast infection so it’s important to see a healthcare provider if you have symptoms. Bacterial vaginosis will not get better without antibiotics.

The CDC recommends any of the following treatments:

• Metronidazole; 500 mg orally 2 times/day for 7 days
• Metronidazole gel; 0.75% one full applicator (5 g) vaginally, once a day for 5 days
• Clindamycin cream; 2% one full applicator (5 g) vaginally at bedtime for 7 days

Antibiotics for chlamydia

Let's turn our attention now to chlamydia. It's an easily detected STI with a simple swab or urine test. Chlamydia often lies dormant, displaying no apparent symptoms, leading to untreated cases persisting for months or even years. It's particularly problematic in women, and can lead to more severe conditions if unchecked.

Chlamydia can lead to pelvic inflammatory disease if not treated.

Chlamydia can be treated with any of these options:

• Azithromycin; 1g orally as a single dose
• Doxycycline; 100 mg orally twice a day for 7 days
• Levofloxacin; 500 mg orally once daily for 7 days

Gonorrhea

Gonorrhea remains one of the most frequently diagnosed STIs and it can be more difficult to treat. After you’ve been treated, it’s important to retest three months later, to make sure it has been fully eradicated.

Antibiotic resistance to gonorrhea has grown at an alarming rate. The usual antibiotics such as quinolone, azithromycin, and extended-spectrum cephalosporins, have high resistant rates from gonorrhea—a worrisome trend since these are often last-line treatment options. Some strains of gonorrhea, like H041 and F89, are proving resistant to common antibiotics like ceftriaxone and cefixime. The CDC no longer recommends cefixime as a first-line treatment for gonorrhea in the U.S.

Treatment consists of ceftriaxone 500 mg in a single dose for persons weighing <150 kg.

Syphilis

Syphilis is an STI that's spread by contact with a sore on the genitals, anus, rectum, lips, or mouth. It can also be spread from mother to child during pregnancy, causing severe complications like early fetal death, stillbirth, or neonatal death. Being highly infectious, this disease places an immense burden on public health worldwide.

Getting a proper diagnosis is important in syphilis cases. The infection stays asymptomatic in its 'latent' stage and is often diagnosed through blood testing.

Syphilis is treated with injections of penicillin G. The dosage and length of treatment depend on the stage and of the disease and your symptoms.

Trichomoniasis (“trich”)

Trichomoniasis, also known as "trich," often doesn’t have any symptoms, but it can lead to a greater risk of catching HIV. It is the most easily treated STI, according to the CDC. The recommended treatment for trichomoniasis is the antibiotic called metronidazole.

What About Resistance?

Antibiotic resistance is a serious public health issue. Chlamydia, gonorrhea, and syphilis all stem from bacterial infections, treatable with antibiotics. These STDs often remain undiagnosed and are becoming progressively more challenging to treat with antibiotics. These difficulties arise due to the misuse and overuse of antibiotics, fueling increased

Strains of multidrug-resistant gonorrhea have been identified that no longer respond to any available antibiotics. Although less common, resistant strains of chlamydia and syphilis have also been observed.

What happens if a person does not treat STIs?

Neglecting to treat sexually transmitted infections (STIs) can lead to other health problems. Untreated STIs can cause permanent damage to your reproductive system and overall health. You're not only increasing your risk of more severe health issues, but you're also risking the health and safety of your sexual partners.

Pelvic inflammatory disease (PID), a potential consequence of untreated chlamydia and gonorrhea, can lead to chronic pelvic pain, ectopic pregnancies, and infertility in women.

Being aware of STI symptoms and pursuing prompt STD testing is a critical step in disease control. Certain STIs don’t have any symptoms, so you may be unknowingly spreading the disease to others.

Health professionals recommend regular screenings and encourage responsible sexual behavior for effective STI prevention. That includes using proper protection during sexual activity—including during oral and anal sex—to reduce your risk of contracting STIs.

Summary box

It's essential to see a healthcare professional right away when STI symptoms surface, as untreated infections can lead to serious reproductive health issues. Regular screenings and protective measures are key to prevention. Be proactive, stay informed, and protect your well-being.

Frequently Asked Questions

What are the severe health consequences of untreated Sexually Transmitted Infections (STIs)?

Untreated STIs can lead to severe health consequences such as long-term reproductive issues. These can include pelvic inflammatory disease (PID) from chlamydia and gonorrhea, and an increased risk of contracting HIV.

What prevention measures can be taken against STIs?

To prevent STIs, it is advisable to use protection during sexual activities, get vaccinated against diseases like HPV, and conduct regular screenings.

What are the most commonly prescribed antibiotics for chlamydia?

The most commonly prescribed antibiotics for chlamydia are doxycycline, taken every day for a week, and azithromycin, one dose of 1g followed by 500 mg once a day for 2 days.