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Antibiotic

Had a question about Azithromycn.  I know that 2g in a single dose is protocol for a gonorrhea infection.  Would the efficacy of this drug & dosage to cure the disease be the same if 1 gram was taken on one day and another 1 gram the next?  I assume this regimen would have the potential to lessen the possible GI side effects.
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Just to clarify, 2 g azithromycin isn't quite "protocol" for gonorrhea treatment at least not in the US.  It is sometimes used for gonorrhea, but never as the drug of choice.  It is somewhat less effective than the recommended regimens, like cefixime or ceftriaxone.  However, it does have the advantage of also being active against chlamydia.  But that's why cefixime or ceftriaxone are always accompanied by azithromycin 1 g (or doxycycline), since chlamydia is often present in peole wiht gonorrhea.  CDC considers 2 g AZM a fallback when other options are unavailable or unsuitable, and I agree -- and I do not agree with those few countries where public health authorities consider the 2 g dose to be a recommended routine regimen.

With that caveat, my guess is that 1 g twice a day apart would be just as effective.  But that regimen has not been studied and I can't recommend it.  Anyway, the current formulation of AZM tablets isn't so irritating to the GI tract as the powder/sachet version or older tablets.  Most people tolerate 2 g (as tablets) pretty well.

I hope this helps.

HHH, MD
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Avatar universal
Thank you for the prompt response.  The person with the potential exposure has already taken the 1g + 1g  2-day dose.  I read in a 2007 article that I found on the net that a 2g one-time dose had a 99% "efficacy", but was, as you said, not being recommended currently for a couple of reasons.  

One last question - would you guess that the 2- day "double dose" had at least a 90% chance of doing the trick with respect to the gonorrhea?  The male who took the medicine did so as a precaution against a single and brief 2-way oral sex event with another man.  He's had no symptoms since the the act 7 days ago.

This is a cool forum.  Thanks again
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Avatar universal
Also, it was unprotected oral sex with no climax. Thank you.
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