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Azithromycin and Bacterial STD's
Dr.
Thank you for a great service. Quick question. I have read lots of your post concerning biaxin and azithromycin and whether they cure syphilis, gonorrhea, chlamydia and NGU. I have found that biaxin is chemically different than azithromycin but biologically same at killing bacteria as azithromycin. On some post you say that azithromycin or clarithromycin(biaxin) would cure all the bacterial stds then in others you state that there could be some problems.
by H. Hunter Handsfield, M.D., Jun 11, 2007 12:00AM
Directly to your questions:
1) Both azithromycin and penicillin are 100% effective in curing incubating syphilis.
by Edward W Hook, MD, Feb 18, 2009 05:41PM
Straight to your questions:
Studies have proven that both ceftriaxone (Rocephin) and azithromycin can cure syphilis.
by H. Hunter Handsfield, M.D., May 19, 2005 12:00AM
Azithromycin is highly effective in preventing syphilis, but not perfect.
by Edward W Hook, MD, Jul 04, 2010 10:04PM
You are right that the data on use of azithromycin for syphilis prevention is worrisome however penicillin (or amoxicillin) is highly active and if you had been exposure to syphilis 5 days of amoxicillin would have cured it.
Please do not th8ink that I am trying to "point a finger". I just wanted to let you know that I have taken the time to research but am still vague on the issue. Would 1.5g of azithromycin taken in a single dose cure syphillis?
Thank you for your time and I hope my post does not offend you.
Thank you for a great service. Quick question. I have read lots of your post concerning biaxin and azithromycin and whether they cure syphilis, gonorrhea, chlamydia and NGU. I have found that biaxin is chemically different than azithromycin but biologically same at killing bacteria as azithromycin. On some post you say that azithromycin or clarithromycin(biaxin) would cure all the bacterial stds then in others you state that there could be some problems.
by H. Hunter Handsfield, M.D., Jun 11, 2007 12:00AM
Directly to your questions:
1) Both azithromycin and penicillin are 100% effective in curing incubating syphilis.
by Edward W Hook, MD, Feb 18, 2009 05:41PM
Straight to your questions:
Studies have proven that both ceftriaxone (Rocephin) and azithromycin can cure syphilis.
by H. Hunter Handsfield, M.D., May 19, 2005 12:00AM
Azithromycin is highly effective in preventing syphilis, but not perfect.
by Edward W Hook, MD, Jul 04, 2010 10:04PM
You are right that the data on use of azithromycin for syphilis prevention is worrisome however penicillin (or amoxicillin) is highly active and if you had been exposure to syphilis 5 days of amoxicillin would have cured it.
Please do not th8ink that I am trying to "point a finger". I just wanted to let you know that I have taken the time to research but am still vague on the issue. Would 1.5g of azithromycin taken in a single dose cure syphillis?
Thank you for your time and I hope my post does not offend you.
Thank you Dr. I am reassured that I did not expose my girlfriend to syphilis.
MEDICAL PROFESSIONAL
Still no chance. You're obviously determined to believe you could have syphilis and to convince me of it. This isn't a debate. This thread is over.
I meant to say that I gave it to her from my exposure(while on the clartihromycin and the doxycycline didn't have time to work and we were sexually active) not that she already had syphilis.
I do not know the statistics but I would think that since I was on those antibiotics right after the exposure and she just had 1.5 grams of azithromycin that the risk would be nil? I do not know how to calculate those statistics. I do not believe I have syphilis my only concern is her.
Thanks.
Thanks.
MEDICAL PROFESSIONAL
Six weeks after a possible exposure, a negative syphilis blood test is 100% reliable, and although clarithromycin may not always be effective, doxycycline is highly active against syphilis. You don't have syphilis and you can't transmit something you don't have.
You're obviously obsessed with syphilis. Let it go; there is simply no chance.
You're obviously obsessed with syphilis. Let it go; there is simply no chance.
I have had an HIV,syphilis,HSV 1 and HSV 2 gon., and chlamydia test done probably 6 weeks post exposure and all were negative. Sorry I just said "all tests were negative". My only concern was that if i was exposed to syphilis during the oral exposure and gave it to my partner even with the antibiotic treatment I was on(clarithromycin then doxycycline) and essentially that could have been what the lesion was on her rectum. However I assume those odds are very very low.
MEDICAL PROFESSIONAL
You describe essentially a zero risk situation with respect to syphilis and your symptoms don't suggest it. Your symptoms and your partner's also don't suggest herpes. However, since herpes is a common cause of genital and anal-area sores, for reassurance you and your partner might talk to your doctor(s) about testing for HSV if that hasn't been done. (I don't know what you mean by "all tests were negative".) For the same reason (reassurance) you could also ask whether a syphilis blood test was done, and if not, have one now. But in the meantime, you really shouldn't be at all concerned about syphilis or other STDs.
Thank you for your clarification. I do not have any reason to believe that I was exposed to syphilis per se. The scenario I am concerned with is one that happened in March 09' when I engaged in receiving oral sex from a female in Tampa,Fla. 3 days after the event I had a sinus infection and was prescribed 500mg er Clarithromycin for 7 days. While on that antibiotic I was bit by a a fire ant and the bite became infected so 100mg twice a day for 7 days. I was on antibiotic treatment for 17days straight.(doesn't it usually take longer than that for a lesion to occur for transmission?) I am pretty sure that my girlfriend and I did not have any sexual relations during the time I was on the Clarithromycin but am not sure during the doxycycline and if we did we usually use for condoms for sexual intercourse. My girlfriend struggles with IBS and one doctor suggested she may have Chrohns disease. She developed a lesion on her rectum in May of 2009. She went to the doctor and they did a culture to see if they could find any bacteria. I am not sure what all they tested for but I do know they tested for herpes. I am not sure whether they took blood for a syphilis test or not. They put her on 10 days of Cipro and the test results came back with just traces of ecoli which they said are normal. The lesion healed within a week or so and we never thought anymore of it. Recently she had a sinus infection and was given a Tri-Pak of Azithromycin. She HATES taking medicine so the doctor told her she could take all three pills at once if she wanted but he didn't suggest it. Well she did. For some reason the lesion and my oral sex episode has really been bothering me. I have been tested after that exposure and all tests were negative. Do you think there is any reason for my fears or concerns? Thanks again for your time.
MEDICAL PROFESSIONAL
Welcome to the STD forum. I'm not sure why you fear this post would be offensive; it's a reasonable question.
Some syphilis bacteria are resistant to all macrolide antibiotics -- azithromycin, clarithromycin (Biaxin), and erythromycin. These strains are common in some geographic areas and apparently absent in others. Unfortunately, the technology to determine resistance is complex and expensive, and therefore data are not available from most geographic areas. Such resistance is common in Seattle, San Francisco, Shanghai, and Dublin, and probably occurs at least occasionally in other places in North America and Europe. From research done by Dr. Hook, such strains apparently are absent in Madagascar and uncommon in the US south and midwest.
For now, CDC recommends against routine use of azithromycin to treat or prevent syphilis in the US, and the equivalent organizations have made similar recommendations in China and Europe. If your risk is high, or if you have been diagnosed with syphilis, I strongly recommend you not rely on azithromcyin and talk to your doctor or clinic about getting a penicillin injection. But if the infecting strain is not resistant, azithromycin is highly effective. If you have been diagnosed with syphilis, your dose is on the low side, 2.0 g is recommended, although most likely 1.5 g would work. If you were only exposed -- i.e. for prevention before the infection takes hold -- 1.5 g is fine.
Of course whether you have or were exposed to syphilis depends entirely on information you don't provide. If you are in North America or Europe and had a heterosexual exposure you are concerned about, the odds are extremely low you were exposed to syphilis. If you're a gay man anywhere, it could be a very high risk.
I hope this helps. Best wishes-- HHH, MD
Some syphilis bacteria are resistant to all macrolide antibiotics -- azithromycin, clarithromycin (Biaxin), and erythromycin. These strains are common in some geographic areas and apparently absent in others. Unfortunately, the technology to determine resistance is complex and expensive, and therefore data are not available from most geographic areas. Such resistance is common in Seattle, San Francisco, Shanghai, and Dublin, and probably occurs at least occasionally in other places in North America and Europe. From research done by Dr. Hook, such strains apparently are absent in Madagascar and uncommon in the US south and midwest.
For now, CDC recommends against routine use of azithromycin to treat or prevent syphilis in the US, and the equivalent organizations have made similar recommendations in China and Europe. If your risk is high, or if you have been diagnosed with syphilis, I strongly recommend you not rely on azithromcyin and talk to your doctor or clinic about getting a penicillin injection. But if the infecting strain is not resistant, azithromycin is highly effective. If you have been diagnosed with syphilis, your dose is on the low side, 2.0 g is recommended, although most likely 1.5 g would work. If you were only exposed -- i.e. for prevention before the infection takes hold -- 1.5 g is fine.
Of course whether you have or were exposed to syphilis depends entirely on information you don't provide. If you are in North America or Europe and had a heterosexual exposure you are concerned about, the odds are extremely low you were exposed to syphilis. If you're a gay man anywhere, it could be a very high risk.
I hope this helps. Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
