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Avatar universal

Failed treatment?

Hello Doctor,

I was diagnosed with Gonorrhea last Thursday and am awaiting the test results for other STDs following a swab, blood and urine sample taken the same day. The sample was sent to the lab within the clinic, which is where they tested for and confirmed Gonorrhea. I was given a shot of Ceftriaxone and a course of Doxycycline 100mg twice daily for 10 days. The symptoms I had were a burning sensation whilst urinating and a constant white/yellow discharge. The doctor I saw at the sexual health clinic has worried me somewhat since she said that the condition is becoming harder to treat due to resistant strains of the infection. My symptoms have improved (no burning sensation when urinating and a small amount of clear/white discharge), but are still present 6 days later. I live in the UK and caught the infection around 9 weeks ago from a British female. I have not had any sexual contact for 4 weeks.

My questions are:

1) How likely/common is it that the Ceftriaxone treatment has failed and what is the next step if this has happened?

2) How long should I leave it before returning to the clinic if the symptoms persist? I have a test of cure appointment mid-Jan, but would prefer to know if the treatment has failed before then to get it sorted.

3) I have been experiencing pain in my left knee (hopefully as a result of a sporting injury). Could this be a symptom of disseminated Gonorrhea? How long does a person need to be infected before the condition spreads? Could this happen in 9 weeks?

4) With New Year’s Eve fast approaching and my last tablet of Doxycycline due to be taken that evening, can I consume alcohol that night without having any negative effect on the medications effectiveness?

Thank you
3 Responses
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300980 tn?1194929400
MEDICAL PROFESSIONAL
Sorry, I o not know the answer to this.  doxycycline however would be unlikely to turn your ejaculate dark.  I doubt it is anythng of concern however.  EWH
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Avatar universal
Thank you doctor, your expertise is greatly appreciated. I have 2 doxycycline tablets left to take, but have one further question. I masturdbated yesterday and noticed that my semen had a dark, almost brownish colour to it. Is this a result of the medication I have been taking?

Thank you
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
Welcome to our forum.  I'll be happy to answer your questions.  I suspect that some of your questions relate to your doctor’s comment that gonorrhea is becoming increasingly resistant to the effect of antibiotics.  This is a true statement but the net effect of this increasing problem is that ceftriaxone is increasingly the preferred drug for gonorrhea treatment.  When given with doxycycline (given because of the possibility of co-infection with chlamydia), the combination of drugs you took is close to 100% effective.  Published studies suggest that about 3% of patients will fail therapy but most experts believe that these so-called failures actually represent re-exposure to an infected partner rather than true failure due to antibiotic resistance.  I would urge you not to worry about the possibility of treatment failure.

Let's work through your questions one by one, using the same numbers you used.

1.  See above. Given what you have told me, there is VERY little chance of treatment failure.  It sounds like you had your infection for some time before you were treated and thus it is not too surprising that it is taking a while for your symptoms to resolve completely.  In addition, I would add that most men have a small amount of normal clear discharge due to the presence of normal genital secretions which is typically overlooked and ignored unless a person is looking for it.  Because of your recent diagnosis, I suspect you are more attuned to this than you normally would be.  I would not worry about the slight discharge you have noted.

2.  As I said above, treatment failure is most unlikely.  Repeat testing will be no help until at least a week after your last dose of doxycycline.  You could go for re-evaluation at that time if you wish.

3.  Unlikely.  the ceftriaxone would have eliminated any risk of disseminated gonorrhea.  I would not worry about your knee pain as a manifestation of infection.

4.  No problem with alcohol consumption.  The only deleterious effect that drinking can have on doxycycline is that it can make people forget to take their medications.

Hope these comments help.  I would not to worry. EWH
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