(Editor's Note: Errata to the guidelines(www.cdc.gov) were published in the Jan. 14, 2011, Morbidity and Mortality Weekly Report. The errors involved dosages recommended for treatment of specific gonorrheal infections and bacterial vaginosis.)
CDC officials last week issued comprehensive new clinical guidance(www.cdc.gov) for the treatment and prevention of STDs in people who have or are at risk for infection. Although the new guidelines, which update the agency's "2006 Guidelines for Treatment of Sexually Transmitted Diseases," focus largely on treatment approaches, they also discuss prevention strategies and diagnostic recommendations.
According to a "Dear Colleague" letter(www.cdc.gov) from the CDC that accompanied release of the guidelines, more than 19 million new cases of STDs are detected each year in the United States, with a disproportionate share of these cases occurring among young people and racial and ethnic minority populations. The estimated annual direct medical cost of treating these infections and their sequelae is $16.4 billion.
The 2010 guidelines were developed using a nearly two-year-long evidence-based process that included CDC and external expert review of the current scientific literature, as well as extensive CDC consultation with a group of professionals knowledgeable in the field of STDs who met in April 2009. The guidelines are intended to "serve as a source of clinical guidance and advise health care providers on the most effective treatment regimens, screening procedures, and prevention and vaccination strategies for STDs," says the agency's letter.
Among newly updated information contained in the 2010 guidelines is the following:
- expanded STD prevention recommendations, including vaccination against human papillomavirus;
- expanded diagnostic evaluation strategies for cervicitis and trichomoniasis;
- revised gonorrhea treatment regimens that reflect the increasing prevalence of antimicrobial-resistant Neisseria gonorrhoeae;
- new treatment regimens for genital warts and bacterial vaginosis;
- assessment of the clinical efficacy of azithromycin for chlamydial infection in pregnant women;
- insight into the role of Mycoplasma genitalium and trichomoniasis in the evaluation of urethritis and cervicitis and treatment-related implications; and
- revised guidance on the diagnostic evaluation and management of syphilis, including criteria for spinal fluid examination to evaluate for neurosyphilis.
Print copies of the 116-page guidelines document are available from the STDs section(www.cdc.gov) of the CDC website. Also available is an audiocast by guidelines lead author Kimberly Workowski, M.D., as well as related fact sheets, brochures and other resources.
In addition, the agency says it plans to develop iPhone and eBook applications of the guidelines, and it encourages health care professionals to visit the site often for continuing product and information updates.