Management of sexually transmissible infections

The epidemiology, diagnosis and management of sexually transmissible infections (STIs) are changing rapidly, making it difficult for the generalist to keep track. Yet, generalists are required to provide the bulk of care for people affected by common STIs. The Table summarises Australasian, European and American guidelines for the diagnosis and treatment of STIs in adults, and is designed to act as a ready reference. The goal in managing bacterial STIs – chlamydia, gonorrhoea, syphilis (Figure 1), and donovanosis (Figure 2) – follows a public health paradigm. That is, we attempt to:

• actively find asymptomatic and minimally symptomatic patients
• cure these patients with antibiotics
• ensure that as many of their contacts as possible are properly managed through contact tracing.