About a week ago I began having pain in my urethra and discharge from my penis (white but somewhat yellowish when dried in my underwear). I suspected it was Gonorreah (but it could have been Chlamydia) so I went to a doctor in Italy as I was on a business trip at the time. Without any testing or even a physical exam, the doctor prescribed Cipro (250 mg/day for 7 days) and Augmentim (875/125) (1000 mg 2x per day for 6 days). I started taking the antibiotics 5 days ago and my symptoms have noticably improved. There was still some white discharge this morning and very slight pain at the tip of my penis when urinating, but everything seems to be getting better.
My concern is that from my own research on the internet the antibiotics prescribed don't seem to be the best choice. I have no allergies to any medication nor am I currently taking any other medication.
Do you think these antibiotics will be adequate? Given that my symptoms are continuing to improve, does that establish that the antibiotics are working and I should stop worrying? Is it possible that if the Gonorreah were resistant to the antibiotics selected that the symptoms would clear up, but that I would remain infectious?
Also, when can I start having sex again without risking infecting my partner? By the way, it won't be the same woman who infected me.
Finally, should I get tested for STD's after the treatment is completed and after how long?
I agree with your self-diagnosis: gonorrhea or chlamydia, or possibly non-chlamydial nongonococcal urethritis (NGU). Yellow discharge and pain slightly favor gonorrhea, especially if onset was within a few days of your last unprotected sexual exposure; the incubation period typically is 7-14 days for chlamydia or NGU.
Either way, your treatment was inappropriate. Of course you should have been examined and tested for gonorrhea and chlamydia. But in any case, your treatment was not eppropriate for any of these three conditions. That doesn't mean it wouldn't work; often either ciprofloxacin or amoxicillin/clavlulanic acid (Augmentin) would be effective, especially against gonorrhea and, less reliably, chlamydia. So I'm not surprised your symptoms are improving -- but I don't think you can or should assume cure, especially if you had chlamydia either alone or along with gonorrhea.
What to do now? If you were my patient, I would recommend stopping the Augmentin and would prescribe treatment at this time with a single dose of azithromycin 1.0 gram. If for some reason that doesn't work out -- if your Italian doc won't prescribe it and you can't find another source -- then I would suggest completing Augmentin for a total of 7-10 days; and about a week later have a test of cure, i.e. a urine nucleic acid amplification test (NAAT) for gonorrhea and chlamydia. As long as those tests are negative, or that you receive azithromycin, and if your symptoms clear up entirely and don't recur in the next couple of weeks, you can safely consider yourself cured.
I hope these comments are helpful. Let me know if anything ins't clear. Best wishes-- HHH, MD
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