Sexually transmitted diseases: an update

Although the 1993 CDC treatment guidelines for STDs contained relatively few changes from the 1989 guidelines, some recently marketed medications now appear in the list of recommended and alternative treatment regimens. Pharmacists must consider differences in dosage formulations (intramuscular versus oral), cost, and length of treatment when choosing the antibiotic or antiviral to be listed in a hospital or managed care formulary. Additionally, pharmacists should recognize that some STD therapies are now given once daily instead of in a 7-day course. When an antibiotic or antiviral prescription order is presented, pharmacists should determine why the patient is receiving this therapy. Verifying the disease process will help the pharmacist counsel the patient on the therapy. In some instances, therapy may be appropriately administered in the emergency room or the pharmacy, to ensure that the patient complies with the medication regimen. Verifying compliance will be especially important for patients who are expected to ingest only one dose, rather than a seven-day course of therapy. By initiating such programs, pharmacists can help prevent drug-resistance problems and ensure compliance.