Sexually Transmitted Disease Prophylaxis

Most of the literature demonstrates poor compliance of sexual assault patients with follow-up.7,1 l8 Therefore, prophylaxis for sexually transmitted diseases (STDs) should be given to all sexual assault victims. At a minimum, treatment for gonorrhea and chlamydia should be offered. The current guidelines from the Centers for

Disease Control and Prevention (CDC) also recommend prophylaxis against Trichomonas and bacterial vaginosis.19 T.a.ble...2.9..0.-.1.. presents the current CDC guidelines for antibiotic choices. A negative pregnancy test should be documented on the chart prior to administering antibiotics; a positive pregnancy test will alter the choice of antibiotics. See Chapte.L1.37 for further information on treatment of STDs. Hepatitis B prophylaxis should be considered if the assailant is felt to belong to high-risk group for the disease. The CDC recommends postexposure vaccination with the first dose administered at the time of the initial exam.19 Administration of hepatitis B immune globin (HBIG) may also be considered. For those who have been vaccinated, a booster and HBIG should be given only if antibody titers are inadequate.

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