8. Genital Tract

Infection	IV treatment	Oral treatment	Total duration
Chlamydia		1st line Doxycycline 100mg BD or 2nd line Azithromycin 1g stat	7 days for patients who are unlikely to comply with a 7 day course
Pelvic Inflammatory Disease In-patient regime	If severe treat intravenously initially Ceftriaxone 1g daily IV plus doxycycline 100mg BD (IV or oral) NOTE: IV doxycycline is unlicensed in the UK	Doxycycline 100mg BD plus metronidazole 400mg BD	Review after 24 hours. If clinical improvement switch to oral Total of 14 days
Pelvic Inflammatory Disease Out-patient regime	IM ceftriaxone 250mg stat,	Doxycycline 100mg BD plus metronidazole 400mg BD or ofloxacin 400mg BD plus metronidazole 400mg BD for 14 days NOTE: Ofloxacin should be avoided in patients who are at high risk of gonococcal PID	14 days
Vulvovaginal candidiasis	.	Clotrimazole pessary 500mg stat plus clotrimazole cream 1% TDS or Oral fluconazole 150mg stat. NOTE: Clotrimazole is the treatment of choice in pregnancy	7 days
Bacterial vaginosis	.	Metronidazole gel 0.75% intravaginal nocte Or Metronidazole 400mg BD orally	5 days

If risk of pregnancy seek further advice

NOTE: Please ensure that the patient's partner(s) are followed up by the GU Medicine clinic
For further advice on treatment of infections of the genital tract please contact microbiology or the Genito-urinary Medicine department via the hospital switchboard