CDC Issues New Sexually Transmitted Disease Guidelines

	SUMMARY: The U.S. Centers for Disease Control and Prevention (CDC) recently issued revised guidelines for prevention, testing, and treatment of sexually transmitted diseases (STDs), published in the December 17, 2010 issue of Morbidity and Mortality Weekly Report Recommendations and Reports. The guidelines -- updated from the previous 2006 version -- feature recommendations for all major STDs, including HIV, as well as hepatitis B and C, which are more often transmitted by non-sexual routes.

By Liz Highleyman

In addition to recommendations for management of specific infections, the report also provides more general guidance on disease prevention and STDs in special populations, including pregnant women, adolescents, and gay/bisexual men and women.

The updated recommendations were developed after an extensive review by CDC staff and experts in the field of relevant medical literature published since the 2006 version. In April 2009, invited experts discussed a draft of the revised guidelines, focusing on key questions that emerged from the literature review.

New information in the 2010 guidelines includes:

	An expanded diagnostic evaluation for cervicitis (cervical inflammation) and trichomoniasis;
	New treatment guidelines for bacterial vaginosis and genital warts;
	Evaluation of the efficacy of azithromycin for treating chlamydia during pregnancy.
	New information about lymphogranuloma venereum among men who have sex with men;
	The role of Mycoplasma genitalium and trichomoniasis in urethritis/cervicitis, and implications for treatment;
	Updated criteria for spinal fluid examination for neurosyphilis;
	Information on emergence of azithromycin-resistant Treponema pallidum (the cause of syphilis);
	Information on increasing prevalence of antibiotic-resistant Neisseria gonorrhoeae (the cause of gonorrhea);
	Discussion of hepatitis C virus (HCV) transmission during sex;
	Updated guidance for diagnostic evaluation after sexual assault.

The full Sexually Transmitted Diseases Treatment Guidelines, 2010 are available online at www.cdc.gov/mmwr/preview/mmwrhtml/rr5912a1.htm.

On January 13, the CDC and the National Network of STD/HIV Prevention Training Centers held the first in a series of "webinars" for health professionals to present the new guidelines. A recording is available on the CDC 2010 STD Treatment Guidelines web page at www.cdc.gov/std/treatment/2010.

Background material related to the literature review and meeting discussions will be published in a supplemental issue of Clinical Infectious Diseases.

1/25/11

Reference
K Workowski and S Berman. Sexually Transmitted Diseases Treatment Guidelines, 2010. Morbidity and Mortality Weekly: Recommendations and Reports. 59(RR12): 1-110 (Free full text.) December 17, 2011.

Other Source
CDC. MMWR: Sexually Transmitted Diseases Treatment Guidelines, 2010. e-HAP Web Update. December 21, 2010.