Guidelines for sexually transmitted diseases

The Centers for Disease Control and Prevention's new guidelines for sexually transmitted diseases stress the importance of early screening, diagnosis and treatment.

The "1998 Guidelines for Treatment of Sexually Transmitted Diseases," updated for the first time since 1993, address several points raised in the Institute of Medicine's 1997 report on the epidemic of STDs in the United States, including consistency and adequacy of care.

Notable changes in treatment outlined in the guidelines include endorsement of single-dose oral therapies for nearly all common, curable STDs.

The guidelines also draw attention to improved treatments for herpes and human papilloma virus. New, recommended therapies may be applied by patients themselves, and may reduce the emotional stress associated with sexually transmitted diseases.

The Centers for Disease Control and Prevention recommends implementing simple urine tests in clinical and non-clinical settings to test for chlamydia. These newer tests may be especially effective in testing in high schools, for example, where large groups of adolescents might be tested. Adolescents, the guidelines note, are at greatest risk for the infection. In one study, as many as one in eight teenage girls tested positive for chlamydia.

The guidelines also recommend more aggressive vaccination of sexually active young people, who are at high risk for hepatitis A and hepatitis B.

Finally, the newer guidelines detail the advances possible in the treatment of STDs during pregnancy. Newer treatments for chlamydia cause fewer side effects, and better screening and treatment of bacterial vaginosis among women with histories of preterm births reduces the number of infants born prematurely as a result of the disease.

Identifying and treating STDs in the estimated 12 million Americans who are infected with them each year can greatly reduce the risks of infertility, potentially fatal tubal pregnancies and debilitating diseases in infants, according the Centers for Disease Control and Prevention.

It may even reduce the contraction and spreading of HIV among women.

The Centers for Disease Control and Prevention will disseminate the new guidelines more aggressively than in years past, officials said.

For more information, physicians and other health care professionals may view the complete guidelines on the Internet at www.cdc.gov./nchstp/dstd/dstdp.html, or order by fax, (404) 639-8628. PR