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Monday, 16 December 2013

Sexual Transmitting Diseases (STD) and Pregnancy - The Treatments

Sexual Transmitting Disease (STD), also known as sexually transmitted infection is an illness which can only transmit through sexual intercourse as a result from the infectious partner or IV drug needles after its use by an infected person, through childbirth or breastfeeding, including vaginal intercourse, oral sex, and anal sex.
Treatments
Conventional medicine
Types of medicine used, depending to the types of sexual transmitting disease, how far into the pregnancy she is and how far the disease has progressed.
Types of treatment in general
1. Antibiotics
For pregnant women infected by hepatitis B and gonorrhea, chlamydia, etc Antibodies are beneficial to the baby with injection at birth.
2. Anti viral medicine
Antiviral pills are beneficial for diseases caused by virus infection, such as herpes. Caesarean section may be necessary if the virus ia active at birth.
3. STD/ HIV/ AID
Antiretroviral drugs are the standard therapy for HIV infection and to prevent the disease to be transmitted to the baby.

Specific treatment
A. Genital Herpes
The medicine used is to reduce the symptoms, not cured. According to the recommendation of the Centers for Disease Control 2010 STD treatment guidelines, your doctor will provide you with corrected dose depending the diagnosis.
1. Adults Experiencing Their First Genital Herpes Outbreak, your doctor may prescribe one of the medicine below.
a. Acyclovir 400 mg orally three times a day for 7–10 days
b. Acyclovir 200 mg orally five times a day for 7–10 days
c. Famciclovir 250 mg orally three times a day for 7–10 days
d. Valacyclovir 1 g orally twice a day for 7–10 days
2. Recurrent Genital Herpes
a. Acyclovir 400 mg orally twice a day
b. Famiciclovir 250 mg orally twice a day
c. Valacyclovir 1.0 g orally once a day
d. Famciclovir 250 mg orally three times a day for 7–10 days
According to the study of Once-daily valacyclovir to reduce the risk of transmission of genital herpes, by Corey L, Wald A, Patel R, Sacks SL, Tyring SK, Warren T, Douglas JM Jr, Paavonen J, Morrow RA, Beutner KR, Stratchounsky LS, Mertz G, Keene ON, Watson HA, Tait D, Vargas-Cortes M; Valacyclovir HSV Transmission Study Group., researchers found that Once-daily suppressive therapy with valacyclovir significantly reduces the risk of transmission of genital herpes among heterosexual, HSV-2-discordant couples.

B. Hepatitis B, C
B.1 Hepatitis B
According to the recommendation of the Centers for Disease Control 2010 STD treatment guidelines. No specific therapy is available for persons with acute hepatitis B; treatment is supportive. Persons with chronic HBV infection should be referred for evaluation to a physician experienced in the management of CLD. Therapeutic agents cleared by FDA for treatment of chronic hepatitis B can achieve sustained suppression of HBV replication and remission of liver disease in some persons. In addition, patients with chronic hepatitis B might benefit from screening to detect HCC at an early stage.

B.2. Hepatitis C
According to the recommendation of the Centers for Disease Control 2010 STD treatment guidelines. No treatment is available for pregnant women infected with hepatitis C virus (HCV). However, all women with HCV infection should receive appropriate counseling and supportive care as needed. No vaccine is available to prevent HCV transmission.

C. Genital warts
According to the recommedation of the Centers for Disease Control 2010 STD treatment guidelines
C.1. Patient-Applied
1. Podofilox 0.5% solution or gel
OR
2. Imiquimod 5% cream
OR
3. Sinecatechins 15% ointment
C.2. Provider–Administered:
1. Cryotherapy with liquid nitrogen or cryoprobe. Repeat applications every 1–2 weeks.
OR
2. Podophyllin resin 10%–25% in a compound tincture of benzoin.
OR
3. Trichloroacetic acid (TCA) or Bichloroacetic acid (BCA) 80%–90%
OR
4. Surgical removal

D. Trichomoniasis
According to the recommedation of the Centers for Disease Control 2010 STD treatment guidelines
D.1. Recommended Regimens
1. Metronidazole 2 g orally in a single dose
OR
2. Tinidazole 2 g orally in a single dose
D.2. Alternative Regimen
1. Metronidazole 500 mg orally twice a day for 7 days
2. Patients should be advised to avoid consuming alcohol during treatment with metronidazole or tinidazole. Abstinence from alcohol use should continue for 24 hours after completion of metronidazole or 72 hours after completion of tinidazole.

E. Syphilis
According to the recommendation of the Centers for Disease Control 2010 STD treatment guideline. the aim of the treatment is to kill the syphilis bacterium and prevent further damage,
1. In early stages. A single intramuscular injection of penicillin, an antibiotic, will cure a person who has had syphilis for less than a year.
2. For patient has had syphilis for longer than a year, additional doses are needed to treat someone who has had syphilis for longer than a year.
3. People who are allergic to penicillin, other antibiotics are available to treat syphilis. Treatment will kill the syphilis bacterium and prevent further damage, but it will not repair damage already done.

F. Chlamydia
According to the recommendation of the Centers for Disease Control 2010 STD treatment guidelines. Chlamydia can be easily treated and cured with antibiotics.
1. A single dose of azithromycin or a week of doxycycline (twice daily) are the most commonly used treatments.
2. HIV-positive persons with chlamydia should receive the same treatment as those who are HIV negative.

G. Gonorrhea
According to the recommendation of the Centers for Disease Control 2010 STD treatment guideline. Recommended Regimens
1. Ceftriaxone 250 mg IM in a single dose
OR, IF NOT AN OPTION
2. Cefixime 400 mg orally in a single dose
OR
3. Single-dose injectible cephalosporin regimens
PLUS
Azithromycin 1g orally in a single dose
OR
4. Doxycycline 100 mg orally twice a day for 7 days

H. STD/HIVAID
Antiretroviral drugs are the standard therapy for HIV infection included Sustiva (efavirenz), Atripla (which contains Sustiva), Viread (tenofovir), and the combinations of Videx (didanosine, ddI) and Zerit (stavudine, d4T) or Zerit and Retrovir (zidovudine or AZT). Viramune (nevirapine).
There are some recommended guide for women who have infected by HIV virus, depending to the severity of the diseases. The aim of the treatment is to prevent the diseases to infect the newborn and to protect the health of the mother. HIV treatment should start as soon as possible, including in the first trimester (three months) of pregnancy. After giving birth, the mother should be re-evaluated and treatment may be needed to for health of the mother.
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