1.5 azithromycin - chlamydia/gonorrhea/syphilis

[sebcr]

I’m not going to go into irrelevant details as to why I made a mistake that led me here. In a nutshell: I had unprotected sex with an unknown and promiscuous person.

It’s been exactly four days; today I took 1.5g of azithromycin as a preventive measure against Chlamydia and maybe gonorrhea and syphilis. I just needed to stop freaking out even though I haven’t developed any symptoms.

I know I should be safe about Chlamydia but I’m not so sure about the other two. I also made the mistake of taking the first gram in the morning (on an empty stomach) and taking the remaining half gram in the early evening (4h after lunch). I did it like this because initially I was planning on taking only 1g but I’m freaking out and I don’t know what to do which is the reason I took half gram more and then I decided to write in here before I do anything else.

I just need your opinion on the matter, it will be highly appreciated. I already know there’s nothing I can do about Herpes, HPV and HIV other than waiting 6 weeks. I’m vaccinated against HBV.

Best regards,

S.

[sebcr]

Excellent. This is the second time in my life I've taken azithromycin. The first time was many years ago and it hurt my stomach a lot back then. This time it didn't even though I took it on an empty stomach to maximize its absorption. Thanks again for your help Dr.

Best regards,

S.

[Edward W Hook, MD]

I doubt very, very much that either your change in appetite or your improved tenonitis is a reflection of treatment of an unidagnosed STD.  There may be an indirect effect independent of possible treatment of infection.  

First, azithromycin directly effects the stomach lining, causing stomach motility to increase.  This in turn may have affected your appetite.  

As for the tendonitis, many antibitoics, including azithromycin has their own anti-inflammatory action, action, independent of infection (like having taken aspirin or ibuprofen).  Perhaps the benefit you note is related to this.  As I said however, it is most unlikely to be related to treatment of an untreated STD.   EWH

[sebcr]

Dr.
I need your feedback one more time. I had opened a separate thread (to be fair and pay again) but I was told I should continue on my thread so I will do it right this time.
I've noticed two positive changes since I took the 1.5g two days ago. The first one is my appetite has increased. The second one is, for some reason some "tendinitis" I had in my right hand has improved dramatically.
For weeks I've been having this mild tendinitis in my right hand, I've been blaming my mouse all this time so I've been trying use it with my left hand every now and then.
Now for some reason it seems to be going away, coincidentally just after I took the pill. Sure, my stress levels also went down but I'd rather hear your professional opinion about whether I could have been suffering from some STD-induced issues without knowing about it. I do consider relevant knowing it there's a chance I could have been carrying an STD for months.

[Edward W Hook, MD]

Glad to help.  Take care.  EWH

[sebcr]

Well as long as it doesn't hurt and I can consider my effective dose greater or equal to 1.0g I guess I can keep calm for a few days. I'm going to get tested for all STDs in two weeks (except HIV which I'm going to postpone for 90 days).
I also decided to take counseling to help me overcome the destructive behaviors that made me act irresponsibly in the past.
Thanks Dr. for your fast and straight answers.

[Edward W Hook, MD]

While the additonal 0.5 gram would logically have some added "kick" and increase effectiveness, there are no data from studies to prove this or to help us know how much is might help.  Sorry.  EWH

[sebcr]

Dr.

Thank you very much for your prompt answer.
Regarding the way I took the dosage, is it still considered 1.5g or 1.0g?
As I mentioned in my previous post I took 1.0g and then 0.5g about 10h later.

Regards,

S.

[Edward W Hook, MD]

I'll try to help.  In doing so I would point out that your assumption that you got any STD from this person is most probably wrong on a statistical basis and that mathematically the chance you got any STD from this is less than 10%.

Your question however is a straightforward, how effective is this dose of medication for these STDs.  here are the answers:

The dose of azithromycin you would take and has been proven effective for treatment of chlamydia and NGU. No question about this.  Studies of gonorrhea done over 10 years ago would suggest that this would cure about 70% of gonorrhea.  finally, when studied over 15 years ago 1.0 gram of azithromycin was highly effective for syphilis prevention.  since then there have been some reports of failure of this dose to prevent syphilis in exposed men who have sex with other men.  

EWH