4.4.3 Suggested Medications for Sexual Assault Survivors

Preventative medications for sexually transmitted infections as well as emergency contraception should be offered to adults and adolescents where child sexual abuse is not suspected.

Testing for STI’s in adults/adolescents is not required. However, medications should be offered as a prophylactic measure.

Below is a summary of medications that can be offered for Sexually Transmitted Infections (STI’s) and as emergency contraception.

For thorough guidance on STI prevention and the recommended treatment for adolescents and adults, view the Centers for Disease Control and Prevention webpage at www.cdc.gov/mmwr/preview/mmwrhtml/00050909.htm.

SUGGESTED MEDICATIONS FOR STI PROPHYLAXIS AND EMERGENCY CONTRACEPTION

Gonorrhea Prophylaxis in Adults and Adolescents (Male and Female):

  1. Ciproflaxin (Cipro) 500 mg PO x 1: Do not administer if pregnant or nursing.

  2. Cefpodoxime Proxetil (Vantin) 400 mg PO x 1: Administer if allergic to Cipro. Safe if pregnant or nursing. Administer if anally or orally penetrated.

Chlamydia Prophylaxis in Adults and Adolescents (Male and Female):

  1. Azithromycin (Zithromax) 1 gm PO x 1: Do not administer if allergic to Erythromycin. Safe if pregnant or nursing.

  2. Doxycycline (Vibramycin) 100 mg PO BID x 7 days: Administer if allergic to Zithromax. Do not administer if pregnant or nursing.

  3. Amoxicillin 500 mg PO TID x 7 days: Administer if allergic to Erythromycins (Zithromax). Safe if pregnant or nursing.

Trichomonas Prophylaxis in Adults and Adolescents (Female):

  1. Metronidazole (Flagyl) 2 gm PO x 1: Do not administer if ETOH has been ingested within 24 hours. Do not administer if pregnant or nursing. If pregnant and nursing, no treatment.

Emergency Contraception in Adults and Adolescents (Female):

  1. Levonorgestrel (Plan B) 2 tablets (0.75 mg each) PO x 1: Administer before discharged from health center. Do not administer after 5 days (120 hours) of assault. Do not administer if pregnant. Safe if nursing. Must obtain a urine, pregnancy test prior to administering Levonorgestrel.

Offer emergency contraception even if the patient is on birth control (Depo shots, BCP, the patch, tubal ligation, post-menopausal, hysterectomy, etc.).

The healthcare facility must inform the patient of emergency contraception and provide the medication if requested by the patient.

Anal Discomfort Treatment in Adults and Adolescents (Male and Female):

  1. Docusate Sodium (Colace) 100 mg capsule PO QD x 7 days: Administer if anally penetrated.

  2. Tucks 1 pad ad. 6 QD x 7 days: prn for hemorrhoids. Do not administer if allergic to witch-hazel.