Indication	Recommended treatments
Bacterial vaginosis
Nonpregnant patients	Metronidazole (Flagyl) 500 mg orally two times per day for seven days
	Metronidazole 0.75% gel 5 g (one full applicator) intravaginally once per day for seven days
	Clindamycin (Cleocin) 2% cream 5 g (one full applicator) intravaginally at bedtime for seven days
	Alternatives:
		Clindamycin 300 mg orally two times per day for seven days
		Clindamycin ovules 100 mg intravaginally once at bedtime for three days
Pregnant patients	Metronidazole 500 mg orally two times per day for seven days
	Metronidazole 250 mg orally three times per day for seven days
	Clindamycin 300 mg orally two times per day for seven days
Cervicitis, presumptive	Azithromycin (Zithromax) 1 g orally in a single dose
	Doxycycline (Vibramycin) 100 mg orally two times per day for seven days plus consider concurrent treatment for gonococcal infection
Chancroid	Azithromycin 1 g orally in a single dose
	Ceftriaxone (Rocephin) 250 mg IM in a single dose
	Ciprofloxacin (Cipro) 500 mg orally two times per day for three days
	Erythromycin base 500 mg orally three times per day for seven days
Chlamydia
Nonpregnant adults	Azithromycin 1 g orally in a single dose
	Doxycycline 100 mg orally two times per day for seven days
	Alternatives:
		Erythromycin base 500 mg orally four times per day for seven days
		Erythromycin ethylsuccinate 800 mg orally four times per day for seven days
		Ofloxacin (Floxin) 300 mg orally two times per day for seven days
		Levofloxacin (Levaquin) 500 mg orally once per day for seven days
Pregnant women	Azithromycin 1 g orally in a single dose
	Amoxicillin 500 mg orally three times per day for seven days
	Alternatives:
		Erythromycin base 500 mg orally four times per day for seven days
		Erythromycin base 250 mg orally four times per day for 14 days
		Erythromycin ethylsuccinate 800 mg orally four times per day for seven days
		Erythromycin ethylsuccinate 400 mg orally four times per day for 14 days
Epididymitis, acute
Caused by gonococcal or chlamydial infection	Ceftriaxone 250 mg IM in a single dose plus doxycycline 100 mg orally two times per day for 10 days
Caused by enteric organisms	Ofloxacin 300 mg orally two times per day for 10 days
	Levofloxacin 500 mg orally once per day for 10 days
Gonococcal infection, genital	Ceftriaxone 125 mg IM in a single dose
	Cefixime (Suprax) 400 mg orally in a single dose
	Ciprofloxacin 500 mg orally in a single dose*
	Ofloxacin 400 mg orally in a single dose*
	Levofloxacin 250 mg orally in a single dose*plus treatment for chlamydial infection, if not ruled out
Granuloma inguinale (donovanosis)	Doxycycline 100 mg orally twice per day for at least three weeks and until all lesions have healed completely
	Alternatives:
		Azithromycin 1 g orally once per week for at least three weeks
		Ciprofloxacin 750 mg orally two times per day for at least three weeks
		Erythromycin base 500 mg orally four times per day for at least three weeks
		Trimethoprim/sulfamethoxazole (Bactrim, Septra) 160/800 mg (one double-strength tablet) orally two times per day for at least three weeks
Herpes, genital
First episode	Acyclovir (Zovirax) 400 mg orally three times per day for seven to 10 days
	Acyclovir 200 mg orally five times per day for seven to 10 days
	Famciclovir (Famvir) 250 mg orally three times per day for seven to 10 days
	Valacyclovir (Valtrex) 1 g orally twice per day for seven to 10 days
	note: Treatment can be extended if healing is incomplete after 10 days of therapy
Suppressive therapy	Acyclovir 400 mg orally twice per day
	Famciclovir 250 mg orally twice per day
	Valacyclovir 500 mg orally once per day
	Valacyclovir 1 g orally once per day
Recurrent therapy	Acyclovir 400 mg orally three times per day for five days
	Acyclovir 800 mg orally twice per day for five days
	Acyclovir 800 mg orally three times per day for two days
	Famciclovir 125 mg orally two times per day for five days
	Famciclovir 1 g orally two times per day for one day
	Valacyclovir 500 mg orally two times per day for three days
	Valacyclovir 1 g orally once per day for five days
Lymphogranuloma venereum	Doxycycline 100 mg orally two times per day for 21 days
	Alternative:
		Erythromycin base 500 mg orally four times per day for 21 days
Pelvic inflammatory disease
Parenteral	Cefotetan (Cefotan) 2 g IV every 12 hours plus doxycycline 100 mg orally (preferred) or IV every 12 hours
	Cefoxitin (Mefoxin) 2 g IV every six hours plus doxycycline 100 mg orally (preferred) or IV every 12 hours
	Clindamycin 900 mg IV every eight hours plus gentamicin loading dose 2 mg per kg IV or IM then maintenance dose 1.5 mg per kg every eight hours (single daily dosing may be substituted)
	Alternatives:
		Levofloxacin 500 mg IV once per day*with or without metronidazole 500 mg IV every eight hours
		Ofloxacin 400 mg IV every 12 hours*with or without metronidazole 500 mg IV every eight hours
		Ampicillin/sulbactam (Unasyn) 3 g IV every six hours plus doxycycline 100 mg orally or IV every 12 hours
Oral	Levofloxacin 500 mg orally once per day for 14 days*
	Ofloxacin 400 mg orally two times per day for 14 days*
	Ceftriaxone 250 mg IM in a single dose plus doxycycline 100 mg orally two times per day for 14 days
	Cefoxitin 2 g IM in a single dose and probenecid 1 g orally in a single dose administered concurrently plus doxycycline 100 mg orally two times per day for 14 days
	Other parenteral third-generation cephalosporin (e.g., ceftizoxime, cefotaxime) plus doxycycline 100 mg orally two times per day for 14 days with or without metronidazole 500 mg orally two times per day for 14 days
Prophylaxis after sexual assault	Ceftriaxone 125 mg IM in a single dose
	Metronidazole 2 g orally in a single dose
	Azithromycin 1 g orally in a single dose
	Doxycycline 100 mg orally two times per day for seven days
Trichomoniasis	Metronidazole 2 g orally in a single dose
	Tinidazole (Tindamax) 2 g orally in a single dose
	Alternative:
		Metronidazole 500 mg orally two times per day for seven days
Urethritis, nongonococcal	Azithromycin 1 g orally in a single dose
	Doxycycline 100 mg orally two times per day for seven days
	Alternatives:
		Erythromycin base 500 mg orally four times per day for seven days
		Erythromycin ethylsuccinate 800 mg orally four times per day for seven days
		Ofloxacin 300 mg orally two times per day for seven days
		Levofloxacin 500 mg orally one per day for seven days