Regulation BEFORE repealed by BC Reg 18/2009, effective March 31, 2009.
| B.C. Reg. 64/84 Regulation of the Minister of Health | Deposited March 8, 1984 |
Venereal Disease Act
Venereal Disease Act Treatment Regulation
Interpretation
1 In this regulation:
"Act" means Venereal Disease Act;
"Canadian Guidelines" means the most current edition of the Canadian Guidelines for the Treatment of Sexually Transmitted Diseases published by Health Canada.
[am. B.C. Reg. 164/97, s. 1.]
Adequate treatment
2 For the purposes of section 1 of the Act, adequate treatment is
(a) for venereal diseases discussed in the Canadian Guidelines, the treatment set out in the Canadian Guidelines and any additional treatment an infected person is directed to take by his or her physician or a medical health officer, and
(b) for venereal diseases not discussed in the Canadian Guidelines, the treatment an infected person is directed to take by his or her physician or a medical health officer.
[en. B.C. Reg. 164/97, s. 2.]
Gonorrhea
| January 24, 1984 | ||
| PREFERRED TREATMENT | ALTERNATIVE TREATMENT | |
| urethral | Ampicillin 3.5 g or | Aqueous procaine penicillin G 4.8 Mu 1.M. plus probenecid 1 g OR Tetracycline 500 mg 4 times daily x 5 days |
| cervical | Amoxicillin 3 g PLUS Probenecid 1 g | |
| rectal | ||
| — female | As for urethral/cervical | |
| — male | Aqueous procaine penicillin G 4.8 Mu 1.M. plus probenecid 1 g | |
| pharyngeal | Aqueous procaine penicillin G 4.8 Mu 1.M. plus probenecid 1 g | Tetracycline 500 mg 4 times daily x 5 days |
| pelvic inflammatory disease | ||
| — outpatient | As for urethral/cervical plus ampicillin 500 mg 4 times daily x 10-14 days | Tetracycline 500 mg po 4 times daily x 10-14 days |
| — hospitalized patients | Crystalline penicillin G 16-20 Mu/day I.V. until improved to be followed by ampicillin 500 mg 4 times daily to complete a 10-14 day treatment period | Cefoxitin 2 g I.V. 8 hourly until improved to be followed by tetracycline 500 mg 4 times daily to complete a 10-14 day treatment period |
| epididymitis/ orchitis | As for urethral/cervical plus ampicillin 500 mg 4 times daily x 10 days | Tetracycline 500 mg 4 times daily x 10 days |
| disseminated gonococcal infection | ||
|
— bacteremia — arthritis/ dermatitis | Crystalline penicillin G 12-16 Mu/day I.V. until improved to be followed by ampicillin 500 mg 4 times daily to complete a 7-10 day treatment period OR As for urethral/cervical plus ampicillin 500 mg 4 times daily x 7-10 days | Cefoxitin 2 g I.V. 8 hourly until improved to be followed by tetracycline 500 mg 4 times daily to complete a 7-10 day treatment period |
| neonates — ophthalmia | Crystalline penicillin G 50,000 u/kg/day I.V. in 2 doses x 7 days PLUS Saline irrigation | |
| children<45 kg — urethral — cervical — rectal | Amoxicillin 50 kg plus probenecid 25 mg/ kg (max 1 g) OR Aqueous procaine penicillin G 100,000 u/ kg I.M. stat plus probenecid (as above) | Spectinomycin 40 mg/kg I.M. |
| penicilinase- producing Neisseria gonorrhoea — urethral — cervical — rectal | Spectinomycin 2 g I.M. | Cefoxitin 2 g I.M. plus probenecid 1 g |
| — pharyngeal | Cotrimoxazole* 9 tablets 4 times daily x 5 days * cotrimoxazole=sulfamethoxazole/trimethoprim | |
All recent sexual contacts must be located, examined, cultured and offered therapy. All patients should return 3 to 7 days after completion of therapy for re-evaluation to ensure efficacy of antimicrobial therapy and to have follow-up cultures obtained from previously infected sites.
All cases must be reported to the local STD control authorities.
If incubating syphilis is a concern aqueous procaine penicillin G should be used. Ampicillin, amoxicillin and tetracycline may not be effective in aborting syphilis. Long acting tetracycline analogs, particularly doxycycline, may be used in place of tetracycline.
PREGNANCY
The penicillins and probenecid are safe during pregnancy. Tetracycline and cotrimoxazole should be avoided. In penicillin allergic patients, spectinomycin may be used although safety for use during human pregnancy has not yet been established. Erythromycin may be used in the same dosage as tetracycline but it is less effective and tests of cure are extremely important when this drug is used.
ORAL PENICILLIN AND LONG ACTING FORMS OF PENICILLIN (BENZATHINE PENICILLIN G) HAVE NO PLACE IN THE TREATMENT OF GONORRHEA.
Syphilis
| PREFERRED TREATMENT | ALTERNATIVE TREATMENT | |
| primary secondary latent of less than 1 year's duration. | Benzathine penicillin G 2.4 Mu I.M. at a single session | Tetracycline 500 mg 4 times daily x 15 days |
| OR | ||
| Aqueous procaine penicillin G 600,000 u I.M. daily x 8 days | ||
| latent of more than 1 year's duration cardiovascular | Benzathine penicillin G 2.4 Mu I.M. weekly x 3 weeks | Tetracycline 500 mg 4 times daily x 30 days |
| OR | ||
| Aqueous procaine penicillin G 600,000 u I.M. daily x 15 days | ||
| neurosyphillis | Crystalline penicillin G 3-5 Mu I.V. 4 hourly for at least 10 days | |
| congenital syphilis | ||
| — normal CSF | Benzathine penicillin G 50,000 u/kg I.M.at a single session | |
|
— abnormal CSF | Crystalline penicillin G 25,000 u/kg I.V. twice daily x 10 days | |
All sexual contacts must be located, examined and treated especially when the index appropriate case is suffering from infectious syphilis.
Pregnant women with syphilis, who have not previously been treated, should receive penicillin in doses appropriate to the stage of the disease. Retreatment during pregnancy is unnecessary unless there is clinical or serologic evidence of new infection. Syphilis serology should be periodically re-examined during pregnancy.
Erythromycin, in the same dosage as tetracycline, should only be used in patients allergic to both penicillin and tetracycline or in penicillin-allergic pregnant women. The efficacy of this regimen has not been well established.
Examination of the cerebrospinal fluid is mandatory to establishing the diagnosis of neurosyphillis.
Individuals should be encouraged to return for repeat serology 3, 6 and 12 months following therapy. Follow-up is particularly important in patients treated with antibiotics other than penicillin.
Chancroid
| PREFERRED TREATMENT | ALTERNATIVE TREATMENT | |
| Erythromycin 500 mg 4 times daily OR Cotrimoxazole* 160/800 mg twice daily for a minimum of 10 days or until ulcer and/or lymph node is healed *trimethoprim/sulfamethoxazole | ||
[Provisions of the Venereal Disease Act, R.S.B.C. 1996, c. 475, relevant to the enactment of this regulation: section 1]