Editorial
On June 5, 2015, the Centers for Disease Control and Prevention (CDC) published revised guidelines for the treatment of sexually transmitted diseases (STDs).1 The document also discusses diagnostic recommendations and prevention strategies. This publication updates the guidelines published in 2010.2 A full report was published in the Morbidity and Mortality Weekly Report (cdc.gov/std/tg2015/default.htm).
Notable features
The new guidelines include recommendations for screening, laboratory testing, and prevention.
Nine important areas highlighted by the CDC
Alternative treatment regimens for Neisseria gonorrhoeae
Use of nucleic acid amplification tests for the diagnosis of trichomoniasis
Alternative treatment options for genital warts
Role of Mycoplasma genitalium in urethritis/cervicitis and treatment-related implications
Updated HPV vaccine recommendations and counseling messages
Management of persons who are transgender
Annual testing for hepatitis C in persons with HIV infection
Updated recommendations for diagnostic evaluation of urethritis
Retesting to detect repeat infection
Webinar
The CDC hosted a webinar on this topic on June 22, 2015. A recording is available at http://www.cdc.gov/std/training/webinars.htm#2015TG/; scroll to the heading “2015 STD Treatment Guidelines Webinars.” Continuing medical education credits (1.5 hours) are offered.
The National Network of STD Clinical Prevention Training Centers (NNPTC) is a fine resource for information on the prevention and clinical management of STDs. To view the national training calendar, register for courses, find resources, and access STD consultation, visit the NNPTC at nnptc.org.
Recommendations for screening pregnant women for STDs
A special section of the report (page 11) focuses on screening recommendations for pregnant women. The document acknowledges that its recommendations are generally broader than others and comments specifically on:
Universal HIV testing, even in previously tested patients
Serologic tests for syphilis
and screening for:
Hepatitis B surface antigen
Chlamydia trachomatis
N gonorrhoeae
Hepatitis C
The CDC concludes that there is no evidence to support screening for bacterial vaginosis in asymptomatic women or routine screening for Trichomonas vaginalis or herpes simplex virus type 2 (HSV-2).
Other areas of emphasis
The CDC now encourages the use of highly sensitive and specific tests based on nucleic acid detection of sexually transmitted microorganisms for both women and men instead of less sensitive tests, such as microscopy (ie, wet prep) and culture (eg, T vaginalis, HSV-2, C trachomatis, and M genitalium). The CDC also makes recommendations about STD assessment in transgender men and women.
New affiliation for AJOG
This year, AJOG became the official Journal of the Infectious Diseases Society for Obstetrics and Gynecology (idsog.org). The Journal will continue to cover important topics in sexually transmitted diseases with additional input from IDSOG.
Photomicrograph (× 200) reveals McCoy cell monolayers with Chlamydia trachomatis inclusion bodies. Such a method is being superseded by nucleic acid methods.
Source: CDC/Drs E. Arum and N. Jacobs, 1975.
Footnotes
The authors report no conflicts of interest.
References
- 1.Workowski KA, Bolan GA. Sexually Transmitted Diseases Treatment Guidelines, 2015. MMWR Recomm Rep. 2015 Jun 5;64(RR-03):1–137. [PMC free article] [PubMed] [Google Scholar]
- 2.Workowski KA, Berman S Centers for Disease Control and Prevention (CDC) Sexually Transmitted Diseases Treatment Guidelines, 2010. MMWR Recomm Rep. 2010 Dec 17;59(RR-12):1–110. [PubMed] [Google Scholar]