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STDs  (Expert Forum)
 | 
Chlamydia, azithromycin, etc.
Answered by
University of Washington Seattle - WA
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

Chlamydia, azithromycin, etc.

by Inkwell, Oct 03, 2007 10:36AM
Hey Doc,

I'm a 40 year old circumcised male.

Last week I had unprotected vaginal & oral sex with an dear friend in a ethical mistake (old story right?).

Within about 48 hours I started to feel a burning, tingling sensation at the tip of the penis and about 1/2 inch down the urethra, feeling the urge to urinate frequently and slight testicular pain. There are no visible sores, lesions, etc. Nor was there any discharge of any kind. Also developed a canker sore under my tongue and a bit of a sore throat, although that's probably incidental.

I went to my doctor five days after the incident, he did a visual examination and then did some kind of urine test in office and said it's not gonnorhea - white blood was normal and the urine was clear he said... He suspected it was chlamydia if it was anything and diagnosed a 3-pack of azithromycin. I screwed up between his directions and the pharmacy and took one 500mg dose day one, and then a 1g dose the following day about 24 hours later. A few concerns here: will this dosage schedule effect the efficiency of the drug for this purpose? And right now, 24 hours after the 1g dose the burning has lessened and become less frequent it is still present - how long does it usually take azithro to relieve symptoms of chlamydia?

by H. Hunter Handsfield, M.D., Oct 03, 2007 01:07PM
As others have already replied (below) before I saw your message, the symptoms came on too soon for chlamydia; if any STD at all was responsible, gonorrhea fits better with the short incubation period.  In any case, you describe a very safe situation from an STD standpoint.  STDs are rare in people in their 40s, and you imply both you and your partner/friend don't have high risk sexual lifestyies.  And indeed if she was taking antibiotics, there is little chance of transmitting anything to you.  Finally, in the very slim chance your doc was right about chlamydia, the azithromycin would have cured it for sure, regardless of the slightly atypical dosage schedule.

Men rarely get the symptoms you describe from a yeast infection.  I would be more suspicious of some sort of chemical irritation.  Statistically, herpes is always a slight possibility, but unlikely without penile blisters/sores.

If your symptoms resolve--which probably they will within a few days--just forget the whole thing.  If they persist, of course return to your doc for further evaluation.  In the meantime, I wouldn't lose any sleep over this (from a medical standpoint--the relationship issue is your responsibility, of course).

Good luck--   HHH, MD
Member Comments (5)

by Inkwell, Oct 03, 2007 10:37AM
Because this incident happened with a dear friend I was able to discuss it freely with her and she reported she has never had to her knowledge an STD (she is a bit of a health nut and hypocondriac and has been in a committed relationship for 8 years..ditto for me), but she went to hey gyno yesterday for tests for chylamidia, gonorrhea - results pending. She did say though that prior to our unfortunate encounter that she had been on antibiotics for a dental condition and had a yeast infection the prior week..and she had one as well at the gyno yesterday.

I know my symptoms might be consistent with a yeast infection as well, but developed no visible signs other than the burning/frequent urination sensation..and I would've suspected the sensation to get worse in taking the antibiotics, which it hasn't...

I appreciate your answers and time taken in this matter...

by infoseekr411, Oct 03, 2007 11:20AM
To: Inkwell
Hi,
I am not a Dr but until he replies, maybe this will help.

I expect that the Dr. will say that the dose of meds you took will clear up the Chlamydia no matter how you took it. That pill is designed to be taken over a short time unlike other antibiotics which you take over a week. I have read that sometimes the "after effects" of Chlamydia could last a few days even after the infection is gone.

Did your Dr test your urine for Chlamydia before you took the meds? If not, you will not be able to determine if you ever did have anything in the first place.

See what the Dr says to be sure but I bet you are going to be fine.

Hope this helps

by J01tx, Oct 03, 2007 12:24PM
To: Inkwell
Timing makes a huge difference.  Antibiotics are to remain in your system at certain levels over a certain amount of time.  The dose/scheduling is in place for a reason.  The infection might appear to go away, only to return in a short while.  The doctor who assessed you would know best what you should do next.  I am not a doc, just a student.

by Tommy420, Oct 03, 2007 12:51PM
To: Inkwell
2 comments:

1) Your symptoms are most likely not due to chlamydia, simply because symptoms of chlamydia don't show up "within 48 hours."  It usually takes at least a week for symptoms to show up.  Such isn't the case for gonorrhea, where symptoms can show up as short as two days.  Although negative WBC may indicate that your urine is not infected, it doesn't necessarily tell you if you have been infected with gonorrhea or chlamydia.  However, if you were infected with chlamydia, a 1gm dose of zithromax would have cleared it up, which you took on the second day.

2) Your symptoms can be due to her yeast infection.  YOu will know for sure once she gets tested.
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