z-pack for chylmidia
by kyoto1, Sep 16, 2008
I have a question regarding some problems I had over a 4 month period.  First after protected sex with CSW(Saw condom when put on but not after) about week later had some uncomfort in penis.  No discharge noticed.  Had painful urination in AM for about 3 days then it went away.  After this i began to feel what felt like pins and needles in groin area.  ALso felt like there would be discharge but when I looked or opened penis there was none.  Penis appeared moist inside.  NOrmal?  Was prescribed a Z Pack taken in the 500mg first day followed by one 250 a day for respritory issue.  NO change in penial symptoms.  Along Ive had diarhhea for four months since this began.  Never any discharge except a miniscule amount of clear one time.  After a while the penile symptoms subcided.  Went to doctor for the urine and diarrhea.  He ran stool and urine sample which were ok.  My question:
1 is are these typical urethritis symptoms?
2Also would the Zpack have cured uretheritis in the dose I took over the week?  
3 4 months of diarrhea related to an STD?  Diarrhea has been consistant in color and texture and smell which is not normal for me.  
4Last question would a Z Pack of the same dose cure MY Sig Other if I gave her anything? (she took same dose for same resp problem)  MY mind has been going crazy looking on net at symptoms of all STDS including HIV.  Please answer and thanks for your service.  I will not follow with any questions to burden you.  
by Edward W Hook, MDBlank, Sep 16, 2008
Azithromycin is effective therapy for the most common causes of urethritis in men (gonorrhea and Chlamydia) but the doses that you took are smaller than what is recommended for STDs and have not been studied.  The dose of azithromycin recommended for chlamydia is 1.0 gram (1000 mg) and the recommended dose for gonorrhea is 2.0 grams.  I suspect that lower doses would cure some urtherits but not all.  My recommendation would be to be re-tested for gonorrhea, chlamydia and nongonococcal urethritis and then be treated if the tests are positive.  

As for your diarrhea.  Antibiotics can cause long lasting side effects including a problem called antibiotic associated diarrhea which can be caused by a bacteria called Clostridium dificile.  There are tests which can be done to evaluate this.  

On to your specific questions:

1.   Your symptoms are really not typical urethritis symptoms.  Most symptoms due to urethritis are mild and include burning on urination and sometimes but not always discharge from the penis.  Pins and needles sensations would be most unusual.
2.  See above.  The drug is effective but you may not have taken enough of it.
3.  See above comment on diarrhea.
4.  If your SO is infected she should be treated with different doses of azithromycin as describe above.

My advice for evaluation of both your urethral concerns and your diarrhea is to go see your own health care provider.  I hope the information I've provided will help you in dealing with him/her.  EWH
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Member Comments (4)
by kyoto1, Sep 16, 2008
The total Z Pack taken was 1500mg  500mg day one followed by 250 a day for four more days.   Would this dose be effective against bacterial STD for me and my SO.  Dont think I had sex with her after penile symptoms but this internet has me a little stressed out.  I no longer have any symptoms except the diarrhea.
by kyoto1, Sep 18, 2008
I have a appointment scheduled for Tuesday.  Just a couple more question if you dont mind.  I had the C Diff test at last Dr. visit and it was negative as well as the stool culture negative.  Is there any other scenarios that you may have that I can run by my Dr. to help figure this diarrhea out that may be STD related? he seems to think from past visit that it is unrelated. I mean do any STDs cause 4 month of diahrrea that no matter what is eaten stays same color texture and smell?  Ive seen in past posts where Dr. HH said a Z-pack would be effective in dose I took.(not doubting you at all just curious about differing comments)  I also took 2 week of doxy for tooth abcess.  would this a few weeks after the z pack effect bacterial  STD's.  Low risk sexual past except this one time protected CSW episode.  Sorry if I am burdening you but these last questions will help me get through til my appointment tuesday.
thanks for you time
by Edward W Hook, MDBlank, Sep 18, 2008
Sorry, nothing to add regarding the diarrhea.

Regarding the Z-pack.  Dr. Handsfield and I agree that the Z-pack will cure most infections, just not as much as the recommended dose.  The two weeks of doxy would be expected to be completely effective however, even after two weeks.  I doubt that your problems are STD-related.  EWH