WHO recommended drug treatment for STIs in pregnancy
| STI | Treatment in pregnancy | ||
|---|---|---|---|
| Source: World Health Organization.115 | |||
| Syphilis | Benzathine penicillin 2.4 million units by intramuscular injection. Three weekly doses recommended in latent syphilis of unknown duration. | ||
| Chlamydia | Erythromycin 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. | ||
| Gonorrhoea | Cefixime 400 mg orally as single dose, or ceftriaxone 125 mg by intramuscular injection. | ||
| Bacterial vaginosis and trichomoniasis | Preferable 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-2 | Primary 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. | ||
| Cautions: | |||
| • 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 | |||