Hesperian Health Guides
Sexually Transmitted Infections: Medicines
Most STIs can be successfully treated with antibiotics. Anti-fungal medicines and medicines to relieve pain are also used. Although not curable, HIV and herpes can be controlled with medicines that will help you feel better and stay healthy.
STI medicines only work when you take all the medicine as recommended. Even if your signs go away, you will not be cured until all the medicine has time to work. If the signs do not begin to go away by 3 days after you started to take the medicines, see a health worker. Pain or vaginal discharge could also be caused by another problem, or you may need a different medicine. Note: All doses given are for adults and children over 12 years old.
Antibiotic medicines fight infection from bacteria. Different antibiotics fight different bacteria. Antibiotics that share the same chemical make-up are said to be from the same family. It is important to know about the families of antibiotics because:
- Antibiotics from the same family can often treat the same problems. This means you can sometimes use a different medicine from the same family.
- If you are allergic to an antibiotic, you will also be allergic to the other members of the same family of antibiotics. This means you will have to take not just a different medicine, but a medicine from a different family instead.
Antibiotics must be given for their full course. Stopping early, even if you feel better, can make the infection return in a form that is even harder to stop. However, if there are serious side effects from the antibiotic, like frequent diarrhea or an itchy rash that spreads throughout the body quickly, you may need to stop using the antibiotic. For help deciding, see a health worker right away.
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Azithromycin
Azithromycin is an antibiotic of the macrolide family used to treat many STIs. It is safe during pregnancy and breastfeeding.
Azithromycin can cause diarrhea, nausea, vomiting, abdominal pain.
Do not use this antibiotic if you have allergies to erythromycin or other antibiotics of the macrolide family.
For gonorrhea, chlamydia, or chancroid:
For pelvic inflammatory disease (PID):
Benzathine penicillin
Benzathine penicillin is a long-acting antibiotic of the penicillin family used to treat syphilis. It is always given as an injection into muscle.
Do not take if you are allergic to medicines of the penicillin family.
Have epinephrine on hand whenever you inject penicillin. Watch for allergic reactions and allergic shock which could start within 30 minutes.
The injection can be painful. Mix with 1% lidocaine if you know how.
For syphilis:
If it is likely that the person has had syphilis for more than a year or has mental or other problems that come after many years of syphilis, a single dose will not be enough. When a test shows syphilis and it is possible that infection was at least 2 years ago or more, inject 2.4 million Units into muscle once a week for 3 weeks. Help the person get the right tests and treatment from an experienced health worker.
Cefixime
Cefixime is an antibiotic of the cephalosporin family used to treat many infections, including gonorrhea.
Cefixime can cause upset stomach, diarrhea, and headaches.
Do not give this medicine to someone who is allergic to other cephalosporin antibiotics.
People who have liver problems should be careful when taking cefixime
For gonorrhea
Ceftriaxone
Ceftriaxone is an antibiotic of the cephalosporin family that is injected into muscle or vein. It is used for many infections, including gonorrhea.
Do not give this medicine to someone who is allergic to other cephalosporin antibiotics.
Ceftriaxone cannot be taken by mouth. When injecting, put the needle deep in the muscle. The injection can be painful, so mix with 1% lidocaine if you know how.
Ciprofloxacin
Ciprofloxacin is an antibiotic of the quinolone family that is used for different infections including chancroid.
Ciprofloxacin can cause nausea, diarrhea, vomiting, headache.
Do not use if you are pregnant, breastfeeding or younger than 16 years old.
Do not take with dairy products.
Drink a glass of water after taking this medicine.
For chancroid:
Clindamycin
Clindamycin is an antibiotic used for different infections including bacterial vaginosis.
Nausea, vomiting, and diarrhea can happen within a few weeks of using clindamycin. If you get a skin rash, stop using it and see your health worker to get a different treatment.
If you are breastfeeding and this medicine gives your baby diarrhea, stop using it.
Using for more than 30 days can lead to thrush and yeast infections, and harm people with kidney or liver problems. The vaginal cream can weaken condoms for up to 3 days after use.
It comes in both capsules to take by mouth and as a vaginal cream.
For bacterial vaginosis:
OR
Insert 5 g of 2% cream (1 full applicator) high in the vagina each night for 7 days
Doxycycline
Doxycycline is an antibiotic of the tetracycline family used to treat many different STIs. It can be used in place of tetracycline and is easier to use because it is taken fewer times each day.
Doxycycline can cause diarrhea or upset stomach. Some people get a rash after staying a long time in the sun.
Do not take if allergic to antibiotics of the tetracycline family.
Do not take doxycycline if pregnant and try to avoid if breastfeeding.
Avoid milk, iron pills, and antacids for 2 hours before or after taking. Do not take just before lying down. Sit up while taking pills and drink lots of water to prevent the irritation that swallowing this medicine can cause.
For gonorrhea or chlamydia:For syphilis in its early stages (with chancre sore or body rash):
Give 100 mg by mouth 2 times a day for 14 days (also give ceftriaxone or spectinomycin).
Erythromycin
Erythromycin is an antibiotic of the macrolide family used to treat many infections, including some STIs. It is safe to use during pregnancy and is widely available, but for most STIs it is no longer as effective as other antibiotics.
Erythromycin may upset stomach or cause nausea, vomiting, and diarrhea.
Do not use if you are allergic to antibiotics of the macrolide family.
Erythromycin works best when taken 1 hour before or 2 hours after a meal. If this upsets your stomach too much, take with a little food. Do not break up tablets because they are coated to protect it against strong stomach juices before it can begin to work in the intestine.
For chlamydia:For chancroid:
For syphilis:
For pelvic inflammatory disease (PID):
Metronidazole
Metronidazole is an antibiotic used to treat bacterial vaginosis (BV), trichomonas, or PID.
Metronidazole can cause a metallic taste in mouth, dark urine, upset stomach or nausea, and headaches.
Do not take this medicine if you have jaundice (yellow eyes) or other liver problems.
Stop taking it if you feel numbness, burning, tingling, or pain in the arms, hands, legs, or feet.
Do not drink alcohol, not even 1 beer, while you are taking metronidazole. It will make you feel very nauseous.
It comes as inserts for the vagina and tablets to take by mouth.
For bacterial vaginosis or trichomonas (or to treat both at the same time)::OR
Give 400 to 500 mg by mouth, 2 times a day for 7 days
OR
Insert one 500 mg insert high in the vagina, every night for 7 nights
Spectinomycin
Spectinomycin is an aminocyclitol antibiotic used to treat gonorrhea, but it does not work for gonorrhea of the throat. It is useful for people allergic to penicillin and cephalosporin antibiotics.
It can cause chills, pain or redness at injection site, dizziness, and nausea.
It comes in vials for injection of 2 g.
For gonorrhea:Tinidazole
Tinidazole is an antibiotic, similar to metronidazole, used to treat some vaginal infections.
Tinidazole can cause a metallic taste in mouth, upset stomach or nausea, or headache.
Avoid this medicine if pregnant, especially in the first 3 months.
Do not drink alcohol, not even one beer, while you are taking tinidazole or for 3 days after. It will make you feel very nauseous.
Drink a glass of water after taking this medicine.
For bacterial vaginosis or trichomonas (or to treat both at the same time):OR
With trichomonas, also treat the person’s sexual partner but this is not necessary if you know it is bacterial vaginosis and the other person has no symptoms.