Cipro treatment?

[SomeoneNC]

I'm a 31 year old (normally healthy) male, sexually active with same-sex activity.  (Always protected, though.)

Went to an "urgent care" center with symptoms of Proctitis (anal soreness, swelling).  Due to some minor mucus discharge the doctor took a swab test and sent off for testing.  

However he went ahead and got me a prescription for Cipro, 500mg twice a day for 20 days.  

He didn't tell me which bacterial STD he felt I might have, nor prescribed any other antibiotic.  (Though I did get some steroidal suppositories for the pain.)

Is it safe to assume that regardless of whether it turns out to be Chlamydia or Gonorrhea, that this one prescription is a general treatment that will fully cure both?    (I'd hate to take this for days and then find out I'm on the wrong pill.)

And if this is the appropriate treatment, will it really take the full 20 days?  I was just hoping to get back to normal before that!

Thanks for the advice.

[Edward W Hook, MD]

I would suggest you discuss this with him. I don't mean to confuse you and hope that i haven't.  this is not such simple stuff, as you can see.  I think you need to have a better idea of what he's thinking before you judge what to do next.  EWH

[SomeoneNC]

Wow...that's confusing.
All I know about the Cipro is that he prescribed it after confirming that I was allergic to penicillin.  But as for the other more appropriate drugs for these diseases, that doesn't explain why I wasn't prescribed them.  
And makes me wonder why I should continue taking 20 days' worth of Cipro if it won't help me?

[Edward W Hook, MD]

It is unclear to me what you were being treated for nor whether you are better as of now or not.  With protected same sex encounters, your risk for STD is very, very low.  

On this forum we try not to second guess health care providers who have the benefit of seeing and examining their patients.  That said, ciprofloxacin is frequently used for therapy of food bourne GI tract infections with great success.  On the other hand, the drug is not reliably effective for chlamydial infections and the frequency of ciprofloxacin resistant gonorrhea in the US now exceeds 20% making it a poor choice for that process as well.  Recommended therapy for sexually transmitted proctitis is a shot of ceftriaxone and 7 days of doxycycline (a single 1.0 g dose of azithromycin may be as good as 7 days of doxy but has not been studied.