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Content Update

December 29, 2019

2019 CDC Antibiotic-Resistance Threats Report: In November 2019 the U.S. Centers for Disease Control and Prevention (CDC) released an updated report on antibiotic resistance threats, last published in 2013. The report includes the latest national infection and death estimates, including 2.8 million antibiotic-resistant infections occurring in the U.S. each year and over 35,000 deaths. The report also notes 223,900 cases of Clostridiodes difficile in 2017 with at least 12,800 deaths. The report provides data on 18 antibiotic-resistant bacteria and fungi in three categories based on level of concern to human health – urgent, serious, and concerning. The report serves as a reference for information on antibiotic resistance and provides the latest estimates on antibiotic resistance burden.

LEARNING OBJECTIVES

LEARNING OBJECTIVES

Upon completion of the chapter, the reader will be able to:

  1. Analyze the behavioral considerations and assess the importance of contraception with regard to the contributing factors of sexually transmitted infections (STIs).

  2. Apply the “patient-delivered partner therapy” method when recommending treatment for STIs.

  3. Identify the patient populations that are typically affected by specific STIs.

  4. Identify causative organisms for STIs.

  5. Devise a list of the clinical signs and symptoms corresponding to each type of STI and classify patients based on recommended criteria.

  6. Select appropriate diagnostic procedures for STIs.

  7. Identify STI treatment regimens and recommend therapy when appropriate.

  8. Design a patient care plan based on the monitoring parameters.

INTRODUCTION

Though we have made significant progress in science and medicine, longstanding problems of infectious disease continue to plague us.1 Even with the discovery of newly improved antibiotics, sexually transmitted infections (STIs) have not been eradicated. Many have reemerged secondary to modern social trends of sexual activity, and some as a result of the human immunodeficiency virus (HIV) epidemic, socioeconomic concerns, and the global lack of preventive education. image Optimal detection and treatment of sexually transmitted diseases depend on counseling by a patient-friendly and knowledgeable clinician who can establish open communication with the patient.

Since the correlation between risky sexual behavior and STIs is well documented,2 most sexually active individuals will ­contract an infection at some point in their lives. Though inconsistent and incorrect condom use increases the probability of new STIs, counseling patients on the consistent use of condoms, spermicides, or diaphragms is an important component in reducing overall incidence.3 Additionally, health care providers who manage persons at risk for STIs should counsel women in a timely fashion concerning the option for emergency contraception, when indicated. Mifepristone, misoprostol, oxytocin, and levonorgestrol have been employed in the United States for the prevention of unintended pregnancy.4

In addition to an increasing number of adolescents engaging in unsafe sexual practices, there is a high incidence of men who ...

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