Chlamydia - Effectivess of less than 1g of Zithromax

[vv17s]

Dear Doctor,

I usually have problems swallowing large tablets, so I crushed up a single 500mmg tablet of Zithromx and mixed it with a bananna shake. I drank most of this, but it was very bitter, and therefore there was some left which I discarded. I then took the other 500mg whole with some water.


I have some questions:

1. Will the dosage I took clear my chlamydia?
2. If yes, when can I start having sex with my partner again? - He has completed his course.
3. When will the symptoms disappear, ie how many days?

I did speak to the pharmacist who dispensed the drug to me. She called the manufacturer (Pfizer) who said to her that Zithromax was OK to be broken up and mixed into food as it is not viewed as slow release, and it does come in a suspension anyway.



I am female, 34 years, 55 kgs, healthy.

Thank you in advance.

[H. Hunter Handsfield, M.D.]

I agree it is OK to take azithromycin with food.  And yes, it is bitter stuff.  I cannot judge how much azithromycin you actually ingested, but it sounds like you probably received close to 90% of the intended dose, and most likely it was enough to do the job.  But to be completely safe, wait 3-4 weeks then return to your provider for a second test to make sure it is negative.  In the meantime, it would be best to use a condom.  (In fact, to be really safe, both you and your partner could both be tested in 3-4 weeks.  If you both have negative tests, you'll know for sure all is well.)  Symptoms of chlamydia--like vaginal discharge, etc--generally will gradually go away over a week or so after treatment.

Good luck--  HHH, MD

[vv17s]

Thank you doctor.  Would it hurt to have another dose of Zithromax (say 500mg) later in the week?

Thanks in adavnce.

[H. Hunter Handsfield, M.D.]

It would be better to just get re-treated with the full 1.0 g dose. Since swallowing large pills is a problem for you, ask your provider to prescribe (or the pharmacy to provide) the 1.0 g single dose powder form of the drug, to be mixed with water. It's still bitter, but it's only a couple of ounces and easy to swallow fast; the bitterness doesn't hit until after swallowing. (Have a small amount of food in your stomach to reduce the risk of nausea and cramping, which are more common with the powder than the pills.)

[vv17s]

Thank you again doctor for you quick response.  I will get anothe 1g in before the end of the week.  My husband took his 1g last monday, and having read the articles published here, he should be OK, however he has noticed that when he "milks" his penis in the morning, he still gets some milky fluid....there is not pain, nor irritation... is this normal?...When will the body naturally overcome the bacteria without and with Zithromax?

Again, thank you very much.

[H. Hunter Handsfield, M.D.]

Only a limited number of new questions can be accommodated daily; follow-up questions should be limited to the original thread to permit others to post their own questions.  I deleted your new question.  

It generally takes a week or more for symptoms to clear up entirely.  If your husband still has abnormal discharge after ~10-14 days, he should return to his provider for reevaluation.  This almost never means continuing chlamydial infection, however.

There are no data on taking 500 mg AZM twice, in the way you describe. It probably would work, but I don't understand why you would want to do it that way instead of the known effective single-dose approach.

Thanks for the thanks, but this will be my last comment. Note that per MedHelp rules, moderators are only obligated to answer the initial question.  On most forums the moderators program their forum access so they never even see follow-up questions and comments!

HHH, MD

[vv17s]

Thank you doctor...peace of mind...priceless.