[Antibiotic treatment for sexually transmitted infections].

Abstract

Background: Sexually transmitted infections (STIs) remain a significant global public health concern. Bacterial STIs such as Treponema pallidum (syphilis), Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium require targeted antibiotic therapy to prevent complications and transmission. However, increasing antibiotic resistance poses a growing challenge in clinical management.

Methods: This article summarizes current antibiotic treatment strategies for bacterial STIs, considering recent clinical guidelines and emerging resistance patterns. It also discusses the role of post-exposure prophylaxis with doxycycline (Doxy-PEP) as a preventive measure in high-risk populations.

Results: Penicillin remains the first-line treatment for syphilis, with alternative regimens required for penicillin-allergic individuals. Chlamydia trachomatis is primarily treated with doxycycline, while azithromycin remains an option for specific populations, including pregnant women. Resistance to third-generation cephalosporins and macrolides increasingly complicates the management of gonorrhea. Mycoplasma genitalium infections demonstrate high resistance to macrolides, often requiring alternative regimens with fluoroquinolones such as moxifloxacin. The emerging use of Doxy-PEP has shown promise in reducing bacterial STI incidence but requires ongoing evaluation regarding its long-term effects on antibiotic resistance.

Conclusion: Effective management of bacterial STI relies on evidence-based antibiotic selection, surveillance of resistance trends, and novel prevention strategies such as Doxy-PEP. Continuous adaptation of treatment guidelines is crucial to counteract the rising threat of antimicrobial resistance in STI pathogens.