Health Alert
DPH GUIDANCE ON TREATMENT OF SEXUALLY TRANSMITTED DISEASES DURING DOXYCYCLINE SHORTAGE

Background

On January 18, 2013 the Food and Drug Administration (FDA) reported a shortage of Doxycycline. Doxycycline is a recommended and frequently used therapy for common sexually transmitted diseases and associated syndromes. Doxycycline tablets/capsules are currently available in very limited supplies.

Recommendations

CDC recommendations and alternative regimens are listed below and also outlined at: http://www.cdc.gov/std/treatment/doxycyclineShortage.htm.

Chlamydia and Nongonococcal urethritis

• Azithromycin 1 g orally in a single dose

Gonorrhea

• Ceftriaxone 250 mg IM in a single dose and Azithromycin 1 g orally in a single dose

Syphilis (In penicillin allergic non-pregnant patients only)

• Primary or secondary syphilis: Tetracycline 500 mg orally four times daily for 14 days
• Late latent syphilis: Tetracycline 500 mg orally four times daily for 28 days

Epididymitis

• Ceftriaxone 250 mg IM in a single dose and Tetracycline 500 mg four times daily for 10 days

Pelvic Inflammatory Disease*

• Ceftriaxone 250 mg IM in a single dose and Clindamycin 450 mg orally four times daily for 14 days, with or without Metronidazole 500 mg orally twice a day for 14 days

*see STD Treatment Guidelines at http://www.cdc.gov/std/treatment/2010/default.htm for additional regimens.

Additional Information

• For additional information about the availability of Doxycycline, visit the FDA drug shortage website at: http://www.fda.gov/Drugs/DrugSafety/DrugShortages/ucm050792.htm
• For additional information about this or any other STD or to report a case, call the DPH Sexually Transmitted Disease Program at 302-744-1050 or visit our web page at: http://www.dhss.delaware.gov/dhss/dph/dpc/stds.html

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