Am Fam Physician. 1999 Jun 1;59(11):2983a-2984.
to the editor: I enjoyed the excellent article, “Management of Female Sexual Assault,” by Drs. Petter and Whitehill.1 I have a comment related to the discussion of prophylactic treatment of sexually transmitted diseases (STDs) in victims of sexual assault. The authors state that treatment “. . . should include prophylaxis for gonorrhea, Chlamydia, and syphilis . . . ,” but that “. . . trichomoniasis should be treated only if seen on the wet mount examination.” The Centers for Disease Control and Prevention (CDC) disagrees.
The CDC's document “1998 Guidelines for Treatment of Sexually Transmitted Diseases”2 regarding sexual assault and STDs recommends empiric postexposure prophylaxis, not only for Chlamydia, gonorrhea and hepatitis (if the patient is not immunized), but also for Trichomonas and bacterial vaginosis, by adding one 2-g oral dose of metronidazole to the usual prophylactic therapy for STDs.
1. Petter LM, Whitehill DL. Management of female sexual assault. Am Fam Physician. 1998;58:920–6.
2. Centers for Disease Control and Prevention. 1998 guidelines for treatment of sexually transmitted diseases. MMWR Morb Mortal Wkly Rep. 1998;47(RR-1):110.
editor's note: This letter was sent to the authors of “Management of Female Sexual Assault,” who declined to reply.
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