1) Treatment options for common sexually transmitted infections

DGRefHelp - NHS Dumfries & Galloway
NHS Dumfries and Galloway

a. Chlamydia (uncomplicated)

Young Person 13 to 15 years old (inclusive)

Preferred treatment

doxycycline 100mg orally twice daily for 7 days1

 

Alternative treatments for urethral, cervical and pharyngeal

Weight greater than 45kg: azithromycin 1g orally as a single dose followed by 500mg daily for 2 days1

Weight less than 45kg: azithromycin 1g orally as a single dose1

If the above alternative treatment is not suitable or need to treat rectal infection, refer to STI and Related Conditions in Children and Young People 2021 and / or seek advice from a senior clinician.

b. Genital herpes

Young Person 13 to 15 years old (inclusive)

Treatment

Acute episode

Weight > 40kg

aciclovir 400mg mg orally three times a day for 5 days1

Suppressive therapy (see adult guideline for indications and cBNF for dosing)

c. Genital Warts

  • Anogenital warts (condylomata acuminata) in young people are often asymptomatic, and require only a simple barrier preparation such as petroleum jelly (Vaseline). Barrier preparations inevitably are oil based, and patients should be counselled that oil based products are likely to damage latex condoms.
  • Observation period for minimum of three months unless symptoms of pain, bleeding or irritation.
  • First line treatment would be cryotherapy with or without local topical anaesthetic1.
  • Podophyllotoxin and imiquimod are licensed for use in adults only. They can be used in young people with specialist advice off-licence. However, these preparations can cause considerable irritation of the treated area and are therefore suitable only for young people who are able to cooperate with the treatment1. Refer to adult guideline for details with regards to which topical treatment preferred and treatment regimes.
  • If all other treatment modalities have failed, consider excision/electro surgery under general anaesthesia.

d. Gonorrhoea (uncomplicated)

Young Person 13 to 15 years old (inclusive)

Preferred treatment

ceftriaxone 1g IM single dose1

If the preferred treatment is not suitable, refer to STI and Related Conditions in Children and Young People 2021 and / or seek advice from a senior clinician.

e. Mycoplasma Genitalium

Refer to STI and Related Conditions in Children and Young People 2021, BASHH Adult Guidance and seek advice from a senior clinician

f. Pelvic Inflammatory Disease (PID)

There are no randomised controlled trials of antimicrobial therapy for PID in children. Recommendations are based on the evidence from adult trials modified for paediatric use. (Preferred treatment below has been agreed by the West of Scotland Managed Clinical Network for Sexual health Guideline Group).

Young Person 13 to 15 years old (inclusive)

Preferred treatment

doxycycline 100mg orally twice daily for 14 days

plus

metronidazole 400mg orally twice daily for 14 days

plus

in the following circumstance empirical gonorrhoea treatment*

  • areas of high gonorrhoea prevalence
  • contacts of gonorrhoea
  • positive microscopy for gonorrhoea (or positive NAAT or culture)
  • severe disease (seek specialist advice)
  • high index of suspicion

*ceftriaxone 1g IM single dose single dose1

g. Pubic lice

Young Person 13 to 15 years old (inclusive)

Treatment

malathion liquid 0.5% in aqueous base1

Apply over whole body, allow to dry naturally, wash off after 12 hours or overnight. Repeat after 7 days.

h. Scabies

Young Person 13 to 15 years old (inclusive)

Treatment

permethrin 5% dermal cream1

Apply over whole body (including face, neck, scalp and ears) wash off after 8-12 hours. If
hands are washed with soap within the 8 hours they should be retreated.
Repeat after 7 days

i. Trichomonas vaginalis

Young Person 13 to 15 years old (inclusive)

Treatment

metronidazole 2g orally in a single dose1

or

metronidazole 400mg orally twice daily for 7 days1

References

  1. BASHH National Guideline on the Management of Sexually Transmitted Infections and Related Conditions in Children and Young People (2021) [accessed 9 July 2024]
  1. British National Formulary for Children [accessed 9 July 2024]

Editorial Information

Last reviewed: 09/07/2024

Next review date: 16/09/2026

Author(s): West of Scotland Managed Clinical Network in Sexual Health Clinical Guidelines Group .

Version: 7.1

Approved By: West of Scotland Managed Clinical Network in Sexual Health