Fast, sensitive molecular diagnostic tests that use urine
or self-collected swabs may lead to more screening opportunities and be more acceptable to patients, resulting
in faster and more accurate diagnosis and treatment of
gonorrhea, chlamydia, trichomoniasis, and Mycoplasma
- Screen for gonorrhea and chlamydia annually—and morefrequently for those at highest risk—in sexually activewomen age 25 and younger and in men who have sexwith men, who should also be screened at the same time for human immunodeficiency virus (HIV) and syphilis.
- Test for Trichomonas vaginalis in women who have symptoms suggesting it, and routinely screen for this pathogen in women who are HIV-positive.
- Nucleic acid amplification is the preferred test for gonorrhea, chlamydia, trichomoniasis, and M genitalium infection; the use of urine specimens is acceptable.
- Consider M genitalium if therapy for gonorrhea and chlamydia fails or tests for those diseases are negative.
- Single-dose antibiotic therapy is preferred for chlamydia and uncomplicated gonorrhea. It is also available fortrichomoniasis, although metronidazole 500 mg twice a day for 7 days has a higher cure rate.