STDs (4) လိင္မွတဆင့္ ကူးစက္သည့္ ေရာဂါေဆးမ်ား
• Gonococcal Cervicitis, Urethritis, Pharyngitis ဂႏုိရီးယားေၾကာင့္ျဖစ္ေသာ ဆီးျပြန္အဝေရာင္ျခင္း၊ သားအိမ္အဝေရာင္ျခင္း၊ အာေခါင္ေရာင္ျခင္း = Ciprofloxacin 500 mg stat or Ofloxacin 400 mg stat
• Uncomplicated Gonorrhea သာမန္ဂႏိုေရာဂါ = Ceftriaxone 125 mg IM stat or Cefixime 400 mg Orally stat or Ciprofloxacin 500 mg stat or Ofloxacin 400 mg stat or Levofloxacin 250 mg or for Penicillin Allergic patients = Spetinomycin 1 Gm IM stat (or) Cefpodoxime 400 mg, (or) Levofloxacin 250 mg daily
• Complicated Gonorhea ရႈတ္ေထြးေသာ ဂႏိုေရာဂါ = Penicillin G 10 million units IV daily x 5 days; Ceftriaxone 1 Gm IV daily x 5 days; Ciprofloxacin 500 mg BD or Levofloxacin 500 mg OD x 5 days; Endocarditis = Ceftriaxone 1 Gm BD IV x 3 weeks
• Gonococcal pharyngitis ဂႏိုေၾကာင့္ အာေခါင္ေရာင္ျခင္း = Ceftriaxone 125 Gm IM, Ciprofloxacin 500 mg orally, and Ofloxacin 400 mg orally
• Systemic gonorrheal infections involving the skin and/or joints အ႐ိုး-အဆစ္-အေရျပား ဂႏိုပိုးဝင္ျခင္း = Ceftriaxone 1 Gm IM/IV every 24 hours, or Cefotaxime or Ceftizoxime 1 Gm IV TDS (or) Ciprofloxacin 500 mg BD or Orofloxacin 400 mg OD x 14 days, along with the treatment for Chlamydia. Human Immunodeficiency Virus (HIV); Hepatitis B = Hepatitis C; Human Herpes Virus 8 (HHV-8)
• Primary Syphilis ပဌမဆင့္ ဆစ္ဖလစ္ = Benzathine penicillin G 2.4 million units IM once or for nonpregnant Penicillin Allergic patient Doxycycline 100 mg BD x 2 weeks or Tetracycline 500 mg QID x 2 weeks or Erythromycin 500 mg QID x 2 weeks
Benzathine penicillin G 2.4 million units IM once a week x 3 weeks; Procaine penicillin G 2-4 million units IM 10-14 days
• Secondary Syphilis (Skin, Mucosal lesions; Memnigitis) ဒုတိယဆင့္ ဆစ္ဖလစ္၊ အေရျပား-ဦးေႏွာက္ေျမွး = Benzathine penicillin G 2.4 million units IM once or Doxycycline for non-pregnant Penicillin Allergic patient 100 mg BD x 2 weeks or Tetracycline 500 mg QID x 2 weeks or Erythromycin 500 mg QID x 2 weeks
• Tertiary Syphilis (Skin, Mucous Membranes, Eyes, Skeltal, Respiratory, GI, Cardiovascular) တတိယဆင့္ ဆစ္ဖလစ္၊ အေရျပား-ဦးေႏွာက္ေျမွး၊ မ်က္စိ၊ အရိုး၊ အသက္ရွဴလမ္း၊ အစာလမ္း၊ ေသြးလွည့္လမ္း = Benzathine penicillin G 2.4 million units IM once or for non-pregnant Penicillin Allergic patient Doxycycline 100 mg BD x 2 weeks or more or Tetracycline 500 mg QID x 2 weeks or more or Erythromycin 500 mg QID x 2 weeks or more
• Neurosyphilis ဦးေႏွာက္-အာရုံေၾကာဆစ္ဖလစ္ = Benzathine Penicillin 2.4 million units weekly x 3 weeks or Crystalline Penicillin G 3-4 million units IV 4 hourly x 10-14 days or Procaine Penicillin 2.4 million units IM OD + Probenacid 500 mg QID x 10-14 days (or) Chloramphenicol 2 Gm daily x 30 days, Doxycycline 200 mg BD x 21 days and Ceftriaxone 1 Gm daily x 14 days
• Prostatitis က်ားဆီးက်ိတ္ေရာင္ျခင္း = Ceftriaxone 250 mg IV single dose + Doxycycline 100 mg Orally BD x 10 days
• Chlamydia (ကလာမိုင္ဒီးယာ) = Azithromycin 1 Gm Orally (or) Doxycycline 100 mg BD Orally x 7 days (or) Ofloxacin 300 mg BD x 7 days
• Lymphogranuloma Venereum (LGV) (လင္ဖိုဂရင္ႏူလိုမား) = Doxycycline 100 mg twice per day by mouth for 21 days
• Genital Herpes လိင္လမ္းေရယံု First Episode ျဖစ္ခါစ၊ Recurrent Infection ျပန္ျဖစ္ျခင္း၊ = Acyclovir 400mg three times/day or 200mg five times/day x 7-10 days; Acyclovir 400mg three times/day or 800mg three/day for 2 days x 3-5 days
• Chancroid ရွန္ကာရြိဳက္ေရာဂါ = Azithromycin 1 Gm stat or a single injection of Ceftriaxone (or) Ciprofloxacin 500 mg BD Orally x 3 days, or Erythromycin, 500 mg QID Orally x 7 days
• Lymphogranuloma Venereum (LGV) Chlamydia trachomatis ပိုးေၾကာင့္ျဖစ္သည္။ ပိုးဝင္အၿပီး ၃-၁၂ ရက္အၾကာ က်ား-မ လိင္အဂၤါမ်ားမွာ မနာေသာ အနာေပါက္မည္။ ေပါင္ျခံတက္ေစ့မ်ား ေရာင္လာမည္၊ ၎တို႔မွ အနာျဖစ္လာမည္။ အစာေဟာင္းအိမ္ ျဖစ္ပါက ဝမ္းသြားလ်င္နာမည္။ Doxycycline 100 mg BD x 21 days; Erythromycin base 500 mg QID x 21 days
• Trichomonas infections (ထရြိဳင္ကိုမိုးနပ္စ္) ပိုးဝင္ျခင္း၊ မိန္းမေတြမွာ ေမြးလမ္းေၾကာင္းကေန အျဖဴဆင္းမယ္၊ ဆီးစပ္နာမယ္။ ေယာက္်ားျဖစ္ရင္ လကၡဏာ မျပဘူး။ ဆီးေအာင့္တာေတာ့ ျဖစ္ႏိုင္တယ္။ Metronidazole 2 Gm တခါထဲေသာက္ပါ။ ဒါမွမဟုတ္ Metronidazole 500 mg BD x 7 days
• PID တင္ပါးဆံုတြင္း အဂၤါမ်ားေရာင္ျခင္း။ သိပ္မဆိုးသူေတြကုိ အျပင္လူနာလို ကုသႏိုင္တယ္။ Ceftriaxone 250 mg IM or Cefoxitin 2 gm + Probenecid 1 mg PO or III generation Cephalosporin + Doxycycline 100 mg BD x 14 days or Ofloxacin 400 mg BD x 14 days + Metronidazole 500 mg BD x 14 days ဆိုးဝါးလို႔ ေဆးရံုတင္ကုသရရင္ Cefotetan 2 gm IV BD or Cefoxitin 2 gm IV QID + Doxycycline 100 mg IV/PO BD or Clindamycin 900 mg IV TDS + Gentamycin IV/IM 2 – 1.5 mg/kg TDS ေစာေစာ သိပါ။ ထိေရာက္ေအာင္ ကုပါ။ ေဆးပါတ္လည္ေအာင္ ကုသပါ။
ေဒါက္တာတင့္ေဆြ
• Uncomplicated Gonorrhea သာမန္ဂႏိုေရာဂါ = Ceftriaxone 125 mg IM stat or Cefixime 400 mg Orally stat or Ciprofloxacin 500 mg stat or Ofloxacin 400 mg stat or Levofloxacin 250 mg or for Penicillin Allergic patients = Spetinomycin 1 Gm IM stat (or) Cefpodoxime 400 mg, (or) Levofloxacin 250 mg daily
• Complicated Gonorhea ရႈတ္ေထြးေသာ ဂႏိုေရာဂါ = Penicillin G 10 million units IV daily x 5 days; Ceftriaxone 1 Gm IV daily x 5 days; Ciprofloxacin 500 mg BD or Levofloxacin 500 mg OD x 5 days; Endocarditis = Ceftriaxone 1 Gm BD IV x 3 weeks
• Gonococcal pharyngitis ဂႏိုေၾကာင့္ အာေခါင္ေရာင္ျခင္း = Ceftriaxone 125 Gm IM, Ciprofloxacin 500 mg orally, and Ofloxacin 400 mg orally
• Systemic gonorrheal infections involving the skin and/or joints အ႐ိုး-အဆစ္-အေရျပား ဂႏိုပိုးဝင္ျခင္း = Ceftriaxone 1 Gm IM/IV every 24 hours, or Cefotaxime or Ceftizoxime 1 Gm IV TDS (or) Ciprofloxacin 500 mg BD or Orofloxacin 400 mg OD x 14 days, along with the treatment for Chlamydia. Human Immunodeficiency Virus (HIV); Hepatitis B = Hepatitis C; Human Herpes Virus 8 (HHV-8)
• Primary Syphilis ပဌမဆင့္ ဆစ္ဖလစ္ = Benzathine penicillin G 2.4 million units IM once or for nonpregnant Penicillin Allergic patient Doxycycline 100 mg BD x 2 weeks or Tetracycline 500 mg QID x 2 weeks or Erythromycin 500 mg QID x 2 weeks
Benzathine penicillin G 2.4 million units IM once a week x 3 weeks; Procaine penicillin G 2-4 million units IM 10-14 days
• Secondary Syphilis (Skin, Mucosal lesions; Memnigitis) ဒုတိယဆင့္ ဆစ္ဖလစ္၊ အေရျပား-ဦးေႏွာက္ေျမွး = Benzathine penicillin G 2.4 million units IM once or Doxycycline for non-pregnant Penicillin Allergic patient 100 mg BD x 2 weeks or Tetracycline 500 mg QID x 2 weeks or Erythromycin 500 mg QID x 2 weeks
• Tertiary Syphilis (Skin, Mucous Membranes, Eyes, Skeltal, Respiratory, GI, Cardiovascular) တတိယဆင့္ ဆစ္ဖလစ္၊ အေရျပား-ဦးေႏွာက္ေျမွး၊ မ်က္စိ၊ အရိုး၊ အသက္ရွဴလမ္း၊ အစာလမ္း၊ ေသြးလွည့္လမ္း = Benzathine penicillin G 2.4 million units IM once or for non-pregnant Penicillin Allergic patient Doxycycline 100 mg BD x 2 weeks or more or Tetracycline 500 mg QID x 2 weeks or more or Erythromycin 500 mg QID x 2 weeks or more
• Neurosyphilis ဦးေႏွာက္-အာရုံေၾကာဆစ္ဖလစ္ = Benzathine Penicillin 2.4 million units weekly x 3 weeks or Crystalline Penicillin G 3-4 million units IV 4 hourly x 10-14 days or Procaine Penicillin 2.4 million units IM OD + Probenacid 500 mg QID x 10-14 days (or) Chloramphenicol 2 Gm daily x 30 days, Doxycycline 200 mg BD x 21 days and Ceftriaxone 1 Gm daily x 14 days
• Prostatitis က်ားဆီးက်ိတ္ေရာင္ျခင္း = Ceftriaxone 250 mg IV single dose + Doxycycline 100 mg Orally BD x 10 days
• Chlamydia (ကလာမိုင္ဒီးယာ) = Azithromycin 1 Gm Orally (or) Doxycycline 100 mg BD Orally x 7 days (or) Ofloxacin 300 mg BD x 7 days
• Lymphogranuloma Venereum (LGV) (လင္ဖိုဂရင္ႏူလိုမား) = Doxycycline 100 mg twice per day by mouth for 21 days
• Genital Herpes လိင္လမ္းေရယံု First Episode ျဖစ္ခါစ၊ Recurrent Infection ျပန္ျဖစ္ျခင္း၊ = Acyclovir 400mg three times/day or 200mg five times/day x 7-10 days; Acyclovir 400mg three times/day or 800mg three/day for 2 days x 3-5 days
• Chancroid ရွန္ကာရြိဳက္ေရာဂါ = Azithromycin 1 Gm stat or a single injection of Ceftriaxone (or) Ciprofloxacin 500 mg BD Orally x 3 days, or Erythromycin, 500 mg QID Orally x 7 days
• Lymphogranuloma Venereum (LGV) Chlamydia trachomatis ပိုးေၾကာင့္ျဖစ္သည္။ ပိုးဝင္အၿပီး ၃-၁၂ ရက္အၾကာ က်ား-မ လိင္အဂၤါမ်ားမွာ မနာေသာ အနာေပါက္မည္။ ေပါင္ျခံတက္ေစ့မ်ား ေရာင္လာမည္၊ ၎တို႔မွ အနာျဖစ္လာမည္။ အစာေဟာင္းအိမ္ ျဖစ္ပါက ဝမ္းသြားလ်င္နာမည္။ Doxycycline 100 mg BD x 21 days; Erythromycin base 500 mg QID x 21 days
• Trichomonas infections (ထရြိဳင္ကိုမိုးနပ္စ္) ပိုးဝင္ျခင္း၊ မိန္းမေတြမွာ ေမြးလမ္းေၾကာင္းကေန အျဖဴဆင္းမယ္၊ ဆီးစပ္နာမယ္။ ေယာက္်ားျဖစ္ရင္ လကၡဏာ မျပဘူး။ ဆီးေအာင့္တာေတာ့ ျဖစ္ႏိုင္တယ္။ Metronidazole 2 Gm တခါထဲေသာက္ပါ။ ဒါမွမဟုတ္ Metronidazole 500 mg BD x 7 days
• PID တင္ပါးဆံုတြင္း အဂၤါမ်ားေရာင္ျခင္း။ သိပ္မဆိုးသူေတြကုိ အျပင္လူနာလို ကုသႏိုင္တယ္။ Ceftriaxone 250 mg IM or Cefoxitin 2 gm + Probenecid 1 mg PO or III generation Cephalosporin + Doxycycline 100 mg BD x 14 days or Ofloxacin 400 mg BD x 14 days + Metronidazole 500 mg BD x 14 days ဆိုးဝါးလို႔ ေဆးရံုတင္ကုသရရင္ Cefotetan 2 gm IV BD or Cefoxitin 2 gm IV QID + Doxycycline 100 mg IV/PO BD or Clindamycin 900 mg IV TDS + Gentamycin IV/IM 2 – 1.5 mg/kg TDS ေစာေစာ သိပါ။ ထိေရာက္ေအာင္ ကုပါ။ ေဆးပါတ္လည္ေအာင္ ကုသပါ။
ေဒါက္တာတင့္ေဆြ