STIs Therapy and Education

Sample Answer

What drug therapy would you prescribe and why?

Ms. J.R would benefit from acyclovir and paracetamol. From her symptoms and those of her partner and the physical examination findings, she probably has genital herpes (herpes genitalis) which is a viral infection mostly caused by Herpes Simplex Virus -2(HSV-2) but can often be caused by Herpes Simplex Virus -1(HSV-1) which is mostly isolated in patients with lesions in or around the mouth. Acyclovir, which is available in oral, intravenous and topical formulations is the gold standard treatment of genital herpes (Kłysik et al., 2020). Paracetamol will act as both an analgesic to relieve her pain and an anti-pyretic for the management of fever.

What are the parameters for monitoring the success of the therapy?

To monitor the success of the therapy administered to J.R, a healthcare provider should probe whether she is still experiencing the symptoms she had while commencing treatment, if they have worsened or she has been relieved of her symptoms. A physical exam to check for the initial positive findings will also come in handy. Ulcer scabs and crusts are indicative of the healing process thus is an important indicator of the success of the therapy administered. A repeat diagnostic test should be done once she is done with therapy to confirm if the virus is still persistent.

Discuss specific education for J.R based on the diagnosis and prescribed therapy

J.R should be advised to have her partner tested and started on treatment since herpes genitalis is usually passed from one person to another (Workowski et al., 2021). She should be advised to abstain during the period of treatment and during active shedding (when vesicles are visible) so as to reduce the risk or reinfection. She should also be informed that once one is infected by this virus she cannot be cured of it but it can go into a latent phase and reactivated when the body is under stress. J. R should be made aware of the importance of fully adhering to medication so as to prevent drug resistance.

Since HSV infections are usually associated with coinfections with other sexually transmitted infections, JR should be educated on her risks of contacting other STIs and advised to be screened for them. This will help prevent the complications from other STIs and possible treatment failure in case of coinfections.

She should be advised on using condoms in the future or microbicides such as gels, creams and lotions to prevent transmission. Since herpes simplex infections can be transmitted to a fetus in utero, she should be advised to take proper caution in the future if she decides to conceive so as to protect her baby from vertical transmission of the virus(Workowski et al., 2021).

References

• Kłysik, K., Pietraszek, A., Karewicz, A., & Nowakowska, M. (2020). Acyclovir in the Treatment of Herpes Viruses – A Review. Current Medicinal Chemistry, 27(24), 4118–4137. https //doi.org/10.2174/0929867325666180309105519
• Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021). Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR. Recommendations and Reports, 70(4), 1–187. https //doi.org/10.15585/mmwr.rr7004a1