Possible infection, treatment question

[Fred069]

Doctor,

Recently I had unprotected oral sex with a very questionable female. About 7-8 days later I started experiencing some burning, tingling and prickly pain after and sometimes during urination. I also seem to have some slight, clear, and maybe milky colored discharge. It is very little, to the point of having to look for it.

The doctor prescribed me Doxycycline 100mg, two times daily and 400mg Suprax taken once. Basic urinalysis was done, with leucocytes and trace blood present. STD testing was, for some reason not performed.

After several days, my symptoms still persist, though they may be somewhat better.

My questions:

1. Would the Doxycicline and Suprax take care of any of the orally transferred STDs that I am at risk for having.

2. How reliably would those drugs work, and how long does it take for them to remove my symptoms?

3. Am I at risk for HIV? If so, do I need to be tested.

4. After finishing my prescriptions, would it be safe to have sex with other partners without risk of transmission.

Thanks you very much for your help

[Edward W Hook, MD]

Yes 2 grams of azithromycin is recommended therapy for gonorrhea but there are reports of some resistance to azithromycin.  If you are really concerned about treatment failure, go get tested again.  EWH

[Fred069]

Sorry,I listed the incorrect antibiotic.

After looking at my prescription it was:

Azithromycin 2g taken once
Doxycycline 100mg, two times daily

NOT 400mg of Suprax.

I had asked about Suprax, as I know it is commonly used, but was prescribed the Azithromycin instead I suppose.

Would this still be effective in treating a gonorrhea infection if one was present? I have recently read about Azithromycin resistance in gonococal bacteria.

Thank you Doctor.

[Edward W Hook, MD]

Welcome to the Forum. from the sounds of things, you did acquire something during receipt of oral sex from your partner.  You may have gotten gonorrhea or NGU.  Both would have been treated with a high degree of reliability with the therapy you received as the cefixime (Suprax) is the recommended therapy for gonorrhea and doxycycline is recommended therapy for NGU.  Both are so effective that it is not necessary to have a follow-up, "test-of-cure" test.  The symptoms typically begin to improve very soon after starting therapy (24 hours) but may not completely resolve for 5-7 days in some cases.  Thus, to specifically answer your questions:

1.  Yes
2.  See above, things should start to get better within 24 hours and then continue to resolve over the next 5-7 days.
3.  No meaningful risk for HIV.
4.  Yes, you can be confident that you will not put other partners at risk after you have completed you medications.

Hope these comments help.  EWH