Z-Pack for Gonorrhea

I was recently traveling overseas and the doctor gave me a Z-pack to treat what he believed to be Gonorrhea. I just finished the dosage provided(over a 5 day period). Is this antibiotic effective for treating Gonorrhea? I finished the treatment today and still have the burning sensation upon urination. Having read the archives I don't see it recommended as a treatment for Gonorrhea? I'm concerned that I may need something else to knock it out of my system. Please advise. Thank you.

[H. Hunter Handsfield, M.D.]

Z-Pack is a trade name for azithromycin, intended for 2 tablets (500 mg) on day 1, then 1 tablie (250 mg) each day for 4 more days.  It is recommended and widely used for things like bronchitis, sinusitis, and certain skin infections.  In a single dose of 1.0 g, azithromycin is one of the standard treatments for chlamydia.  For gonorrhea, the 1.0 g dose isn't quite enough, as single dose treatment; but 2.0 g (eight 250 mg tablets) often works well.

The Z-pack regimen over 5 days hasn't been studied against gonorrhea.  It probably would work, but there is a small chance it will not.  If you are a man and have urethral symptoms--discharge, etc--then if those symptoms go away and stay away, you can be confident you were cured.  But genital gonorrhea in women or rectal infection often cause no symptoms and you won't be able to tell with certainty.  In that case, your choices are to request additional therapy now; or to return to the provider for a test of cure 1-2 weeks after you finish treatment.

If you are in an industrialized country, with a little local reseach you probably can find a public health STD clinic (in UK they are called genitourinary medicine, GUM clinics) for direct advice and perhaps retesting.  The good news is that if you also have chlamydia--as 20-40% of persons with gonorrhea do--the azithromycin will clear it up.

Good luck.  Continue your travels safely--and I don't just mean seat belts!

HHH, MD

[tnt406]

HI DOCTOR H.MD. I WANTED TO COME OVER AND APOLOGIZE FOR MY BEHAVIOR ON THE WOMENS HEALTH FORUM.I AM GOING THROUGH A HARD TIME RIGHT NOW,I KNOW IT'S NOT NO EXCUSE FOR MY BEHAVIOR.BUT MY DOCTOR DOES NOT WANT TO LISTEN TO ME.I LIEVE IN A SMALL TOWN, SO THERE ARE NOT THAT MANY DOCTORS IN THIS AREA,THAT CAN REALLY TREAT ME.UNFORTUNATELY YOU CAN'T EITHER YOU SPECIALIZE IN ANOTHER FIELD OF MEDICINE.I DON'T HAVE A CREDIT CARD ANY WAYS.I JUST WANTED TO APOLOGIZE FOR MY BEHAVIOR AND HOPE YOU EXCEPT IT.AND HOPEFULLY YOU WILL JOIN US BACK ON THE WOMENS HEALTH FORUM.SOME TIMES WE DO NEED A DOCTOR OVER THERE MAYBE YOU COULD POP OVER ONCE A MONTH TO HELP SOME OF THE WOMEN WHO HAVE INFECTIONS IN THERE PELVIC REGIONS.I KNOW I SHOULDN'T HAVE ASKED BUT I FEEL SO BAD FOR SOME OF THEM.AT LEAST YOU CAN THINK ABOUT IT.YOU CAN REACH ME OVER AT WOMENS HEALTH FORUM MY NAMES TNT406.HAVE A NICE BRIGHT CHEERY DAY DOCTOR H MD. TNT406

[H. Hunter Handsfield, M.D.]

That is a very nice message and I appreciated it. Apology accepted!

It isn't practical for me to consistently participate in the women's health forum, and since it is intended for non-health professionals might antagonize some users.  But of course participants there with infection concerns can pop over here any time--although my expertise is STDs in particular, less expert in other gynecologic infections.

Best wishes--  HHH, MD

[tnt406]

THANK YOU,I'LL TALK TO YOU LATER BYE BYE.TNT406   P.S.TAKE CARE OF YOUR  SELF.

[monkeyflower]

Well, this post piqued my curiosity, so I just had to check the Women's forum out. It was really nice of you to go there in the first place, let alone go back after the responses to your post. That was seriously bizarre, but I guess that attitude is why so many people remain so willfully misinformed. Anyway, for the record, I think you do an amazing job. I've learned an enormous amount from reading your replies, and I'm totally grateful that you're here. You offer a balanced, sane view of STDs that is such a welcome change from so many other sites. Thanks, as always.

[cheche814]

Quick question. Im a man that had epiditimytis over 20 years ago and the testicles were very enlarged. The Dr. put me on antibiotics and since then, I have always had a painful sensitivity in my right testicle while my left there is not pain. There is a hard lump pr nodule that when gently palpated is quite painful but I also notice that the epiditimis feels very thick and filled with a mass. could this be an std? I went back to my family Physician and he wanted to insert a needle and take a sample. I could not even fathom the thought let alone do it as the pain would be excruciating. I also have prostitis and spleeno hepatomegaly. Test shown no hepatitis or anything like that but they also wanted to do a liver biopsy but was afraid again due to the pain of them performing it while conscience. what are your thoughts and what possibilities is it that it caould be or is an STD? Thank you.