Table 3

 WHO recommended drug treatment for STIs in pregnancy

STITreatment in pregnancy
Source: World Health Organization.115
SyphilisBenzathine penicillin 2.4 million units by intramuscular injection. Three weekly doses recommended in latent syphilis of unknown duration.
ChlamydiaErythromycin 500 mg orally four times a day for 7 days, or azithromycin 1 g orally single dose, or amoxycillin 500 mg orally three times a day for 7 days.
GonorrhoeaCefixime 400 mg orally as single dose, or ceftriaxone 125 mg by intramuscular injection.
Bacterial vaginosis and trichomoniasisPreferable after the first trimester
 > Metronidazole 200 mg or 250 mg orally three times a day for 7 days, or metronidazole gel 0.75%, one full applicator (5 g) intravaginally twice a day, or clindamycin 300 mg orally twice a day for 7 days. For trichomoniasis 2 g metronidazole stat recommended as first line treatment.
HSV-2Primary infection only
 > Aciclovir 200 mg orally five times a day for 7 days, or aciclovir 400 mg orally three times a day for 7 days. Recurrent infection
 > Famciclovir 125 mg orally three times a day for 5 days, or valaciclovir 500 mg twice a day for 5 days.
• Doxycycline, tetracycline, ciprofloxacin, norfloxancin, and ofloxacin should be avoided in pregnancy and when breast feeding.
• Erythromycin estolate is contraindicated in pregnancy because of drug related hepatoxicity; only erythromycin base or erythromycin ethylsuccinate should be used.
• Metronidazole should be avoided in the first trimester of pregnancy