treatment effective

though practicing safer sex, about 9 days after a sexual encounter i had some urethral discomfort, followed a day later by burning while urinating and then increasing milky discharge.

i went to my doctor who took a urine sample and a swab and then put me on two 250mg doses of cipro per day.  the symptoms subsided in 12 hours and were almost entirely gone in 24 hrs.

3 days later he called me and said that there was some scant evidence of gonorrhea from the culture.  he told me to take a double dose of the cipro that night (500mg) and prescribed a 500mg dose of azithromycin to take with it.  the symptoms seem to have disappeared.

i've heard a lot about antibiotic resistant strains of gonorrhea.  is that something i should worry about?  or should the medicine have done the trick, given that the symptoms subsided quickly?

[Edward W Hook, MD]

You do not tell us where you are from however, here in the US, the treatment received was a little less than what is recommended by the CDC.  As you point out, an increasing proportion of gonorrhea is now resistant to ciprofloxacin and related antibiotics.  As a result, it is no longer recommended for therapy.  

The CDC's treatment guidelines are meant to provide about a 97% cure rate for persons treated as recommended.  Your treatment, while likely to have cured you, may have also transformed it from a symptomatic infection to an asymptomatic one.  Recommended treatment for gonorrhea in the U.S. is now ceftriaxone, at least 125 mg given as a shot, followed by either a single 1.0 gram dose of azithromycin or, alternatively, doxycycline, 100 mg taken twice daily for 7 days.  Finally, anyone you have had sex with in the past 30 days should be evaluated and treated.  Hope this helps.  EWH

[jerry1972]

i live in the US, east coast.  heterosexual male.

when the doctor received the test results, he prescribed the same for my partner.  he tends to be very conservative with antibiotics and i'm not sure how up to date he is with CDC recommendations.   do you think, then, that i should go back to my doctor and ask for further treatment and/or further testing?

[Edward W Hook, MD]

I would at least rasie the issue.  he may prefer to perform a test of cure test.  If he does that and the gonorrhea is gone, then you are cured.  EWH

[koko_ako]

A related discussion, What antibiotics should i take if i was positive for gonorrhea was started.