Azithromycin dosage for treating Chlamydia

[Sigurt]

Hi Dr H. Hunter Handsfield,

and thanks for this excellent forum.

I'll get right to the point

Will a treatment of 500mg of Azithromycin taken at evening time, followed by 500mg taken the following morning, followed by 250mg the next day, then another 250mg the day after that treat most cases of Chlamydia ?

and also, will this same dosage above cure a possible Gonorrhea infection or Syphilis ?

Thanks for your help,
Sigurt

[Edward W Hook, MD]

Correct.  I anticipate that the therapy will ahve worked but the only way to be sure is with re-testing.  EWH

[Sigurt]

Thank you Dr. Hook for your prompt reply.

yes, have been reading up on this and the 1.0gram dose of azithromycin recommended in one single dose. I actually did take this myself on Friday, but my partner who did not listen to the instructions on dosage, took the above mentioned dosage.

So basically, 1.0grams in a 8hr window, followed by 250mg 24 hrs later and 250mg 24 hrs later to that.

I still feel a tiny bit tingling feeling and can see a slight discharge. how long do you think it would take to normally clear up after you take the 1.0grams of azithromycin. In fact, come to think of it. I think I actually took 1250mg in one go of it to be extra sure.

I guess the only way to know is to get tested again

Thanks alot
Sigurt

[Edward W Hook, MD]

Welcome to our Forum.  Dr. Handsfield and I share the forum.  You got me.  FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.

This is a difficult question to answer with 100% confidence.  The doses of azithromycin studies for treatment of chlamydia, NGU, and gonorrhea have been studied when the medication is taken as single doses.  Thus, questions about doses taken at lower doses and on different schedules is difficult to answer and require estimation of their effectiveness as opposed to answers based firmly on scientific studies.  When multiple doses of the drug are taken over them time maximal level of drug achieved in the blood is not the same as when it is taken over a longer period.  

As you probably know, we know that a single 1.0 gram dose of azithromycin will cure nearly all chlamydial infections and is the recommended therapy for NGU.  For gonorrhea the 2.0 gram dose is recommended.  The 2.0 gram dose is also the dose shown to be effective for syphilis.  

You describe taking 1500 mg (1.5 grams) over about 3 days.  This dose would probably cure most chlamydial infection and NGU and some gonorrhea or syphilis but not all.  Beyond that, there really no way to answer your question with complete confidence.  EWH