Antibiotics and sexually transmitted diseases.

There have been gratifying decreases in the rates of several major treatable STDs. These decreases show that diligent application of current preventive and management approaches can be effective. These improvements have not necessarily been reflected as great changes for populations at greatest risk, particularly younger women and those in certain geographic locales or in certain ethnic groups. The CDC 1993 STD guidelines provide updated recommendations for treatment, with key innovations, including an indication of the strength of evidence for certain recommendations, expanded discussions of syndromes, and modifications required in treating infection with HIV. There are many areas in which recommendations concerning efficacy are based on insufficient data. In addition to evaluation of new anti-infectives, key areas for future research are issues of compliance and effectiveness, advantages and appropriateness of liberal treatment of core group or selected populations, and impact of treatments for one STD on risk of transmission of others, particularly HIV. Further study is required on the effects of adjunctive treatments of diseases such as PID.