Table 2 First-line treatment regimens and clinical and microbiological cure rates for national syndromic treatment guidelines by syndrome
SyndromeTreatment regimenCurable STI aetiologynPercentage curedReference
Clinical % (n)Microbiological % (n)
Urethritis500 mg single dose ciprofloxacin since 2001 (250 mg before 2001) and 200 mg of doxycycline daily for 7 daysNG135100 (135)100 (135)13
CT24100 (24)83 (20)
UlcerOne intramuscular injection of 2.4 million units of penicillin and 500 mg dose of erythromycin 4 times daily for 5 days.TP2889 (25)14
No treatment for HSV-2HD3093 (28)
CT (LGV)2993 (27)
Vaginal discharge500 mg single dose ciprofloxacin and 100 mg of doxycycline 2× daily for 7 days and 2000 mg metronidazole single dose, or 400 mg metronidazole 2× daily for 7 daysNG5165 (33)80 (41)11
CT4469 (30)89 (39)
Or if pregnant: one intramuscular injection of 125 mg ceftriaxone and erythromycin 500 mg 4× daily for 7 days and 400 mg metronidazole 2× daily for 7 daysTV11365 (73)88 (98)
NG11100 (11)12
Or if cervical excitation tenderness: 500 mg single dose ciprofloxacin and 100 mg of doxycycline 2× daily for 14 days, and 400 mg metronidazole 2× daily for 14 daysCT1080 (8)
TV4489 (39)
  • CT, Chlamydia trachomatis; HD, Haemophilus ducreyi; HSV-2, herpes simplex virus type 2; LGV, Lympho-granuloma venereum; NG, Neisseria gonorrhoeae; TP, Treponema pallidum; TV, Trichomonas vaginalis. Guidelines adapted from.6