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STDs (Expert Forum)
Proper Treatment for STD
Answered by
Edward W Hook, MD - HIV Prevention, stds
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.
Proper Treatment for STD
by switchback5621, Jun 23, 2009 06:57AM
I always practice vaginal sex with a condom but oral sex is sometimes without. I realize from reading here that oral sex is not a good way to contract an STD but none the less I believe I contracted one because of a mild white discharge from my penis and a slight pain the second or two after urination. I went to a local doctor (in the Czech Republic) and he told me that it is most likely Chlamydia or Gonorrhea or something else I did not understand and prescribed a 3g gram single dose of Amoxicillin (6 pills!). That was less then 48 hours ago and I promptly took the medication but the symptoms have not yet changed. From what I have found on the internet a single dose of Amoxicillin does not appear to be the correct treatment for either Chlamydia or Gonorrhea. He did not do any test other then a physical inspection of my penis and ask me about my symptoms. I was expecting the doctor to take blood or urine or something but that never happened. I am now second guessing his diagnosis and treatment but wanted to ask here before I run and visit another doctor. So my questions are:
1. Is it normal to prescribe an antibiotic without any physical testing?
2. Is a 3 gram single dose of Amoxicillin an effective treatment to Chlamydia, Gonorrhea or any STD with my symptoms?
3. If Amoxicillin is not the proper treatment what is?
4. If the answer to question 2 to is yes, how long will it take for the medication to work?
Thank you for your advice and opinions, this site has been quite helpful.
1. Is it normal to prescribe an antibiotic without any physical testing?
2. Is a 3 gram single dose of Amoxicillin an effective treatment to Chlamydia, Gonorrhea or any STD with my symptoms?
3. If Amoxicillin is not the proper treatment what is?
4. If the answer to question 2 to is yes, how long will it take for the medication to work?
Thank you for your advice and opinions, this site has been quite helpful.
Doctor's Answer
by Edward W Hook, MD, Jun 23, 2009 09:10AM
, Jun 23, 2009 09:10AM
You are correct that in most nations single doses of amoxicillin are no longer recommended for treatment of gonorrhea.
The symptoms you have suggest that you have either gonorrhea or nongonococcal urethritis. Without a test one cannot tell which is present. If testing is not available, the recommended treatment would be either a single injection of ceftriaxone or cefixime in a single dose of 400 mg, FOLLOWED by either a single dose of azithromycin or 7 days of doxycycline 1000 mg twice daily. this therapy will provide reliable therapy for both gonorrhea and NGU. Chlamydia is not a concern as it does not regularly infect the throat and therefore cannot be acquired from oral sex but, if it was there, this therapy would cure it as well..
In answer to your specific questions:
1. In some settings if testing is not available, health care providers will just treat following observation of a discharge.
2. No
3. See above
Hope these comments help. EWH
The symptoms you have suggest that you have either gonorrhea or nongonococcal urethritis. Without a test one cannot tell which is present. If testing is not available, the recommended treatment would be either a single injection of ceftriaxone or cefixime in a single dose of 400 mg, FOLLOWED by either a single dose of azithromycin or 7 days of doxycycline 1000 mg twice daily. this therapy will provide reliable therapy for both gonorrhea and NGU. Chlamydia is not a concern as it does not regularly infect the throat and therefore cannot be acquired from oral sex but, if it was there, this therapy would cure it as well..
In answer to your specific questions:
1. In some settings if testing is not available, health care providers will just treat following observation of a discharge.
2. No
3. See above
Hope these comments help. EWH
