It would be quite difficult to handle this without your help. Thanks very much.
As I said above, particularly if you are in a setting where it may be difficult to be followed closely by experts, I would prefer the doxycycline listed above. At the very least, if you are treated with azithromycin it is important that you be followed closely with blood tests for response to therapy. EWH
Thanks for such a kindness. This will be my last post.
I dont think I will be able to go to the doctor in the next few weeks.
Do you think 2g of azithromycin (4 tablets of 500mg at once) could be enough also for syphillis?
Thanks again.
The 2.0 gram dose of azithromycin will cure gonorrhea.
Given your limited access to medications, my advice would be for you to seek therapy with doxycycline 100 mg twice daily for 14 days. This is the recommended alternate therapy for treatment of early syphilis. If you have gonorrhea you could take either the azithromycin as a single 2.0 gram dose or cefixime. The CDC has only recently (last week) recommended against cefixime for gonorrhea therapy, when possible, thus I would probably go with the 2.0 gram dose of azithromycin. EWH
Unfortunatelly, I am not in San Francisco anymore. I was there for just a couple of months. At that time I went to City Clinic STD in San Francisco. It is really excellent.
Currently,I live in a region in South America where there is a strong lack of resources. I got syphillis here in South America about 4 weeks ago.
I got just one box of azithoromycin (5 x 500 mg tablets). I didnt take the medication yet. So, please, allow me just two more questions:
1)Do you think it would be a good idea to talk to my doctor about the possibility of taking 4 tablets (500mg) at one time, instead of 500mg for 5 days?
2)They suspect I can also have gonorrhea. Just in case, will the 2g azithoromycin dosage cure it as well? I know that cefixime is also recommended, but due to lack of resources I would like to know if 2g azithoromycin would be enough.
PS.: the lesion is in anus.
Thanks again for your help.
Welcome back to our Forum. In reviewing your past threads I note that you recently had a sore on your abdomen- it this thought to be your syphilis lesion?
As chance would have it, I have lead most of the research that has been done on azithromycin for syphilis therapy. A number of studies have shown that azithromycin in a dose or 2.0 grams (4 500 mg pills) taken at one time is just as effective as penicillin for syphilis treatment however, there are some cases of treatment failures with azithromycin for syphilis treatment and many of the treatment failures have come from San Francisco where you apparently live. Thus this is a matter of concern.
While many people will be cured by therapy of early syphilis with azithromycin, the dose you have received is not the recommended dose. It is also being given over too long a period of time. In addition, because of the potential for treatment failures, you need to be carefully followed and have your infection further evaluated.
The San Francisco Department of Health has an excellent STD Clinic staffed by knowledgeable experts. I strongly recommend that you go there to get checked out. They may wish to provide alternative therapy with a medication like doxycycline – that is what I would do.
I hope this information is helpful to you. Please let us know how things progress for you. EWH