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Were these antibiotics effective against gonorrhea?

Hello Doctors,
Thank you for your contribution in this forum! I myself am a greatful 29yo female from Greece.
June 2009 I was diagnosed with chlamydia.Gyn prescribed Levofloxacin (Tavanic 500mg 1/d for 14d). I was infected with chlamydia before that and was treated with Doxycycline (Vibramycin 100mg, 2/d for 14d), but I had an uncomfortable light sensitivity reaction to it. At the time I had 2 different partners.They both took Roxithromycin (Rulid 300mg 1/d for 14 d), both said they prefered Rulidx1 than Vibramycinx2/d. I know for sure that partn2 completed the treatment, don't know about partn1,(who gave me the infection). Partn2 (to whom I passed it) had some symptoms for 3-4 days (some inflammation and burning feeling,but no discharge that I recall) that went away and never came back. I tested after treatment and was infection-free! My 2 partners were never tested.
Over the past year I have had a 2-day episode of inflammation following some unprotected frottage/oral (NO unprotected intercourse) with partn1 and what seems to me as extra vaginal discharge fom time to time (always white, not itchy)so I decided to get tested for chlam again. The culture came back -. But I suspect it was not done correctly...1)Isn't a sample from the cervix required? the nurse never used a vaginal speculum, just a long q-tip.
I plan to re-test & wonder if maybe what I had last year was a chlamydia+gonorrhea co-infection. I was never tested for gon, but a year ago, partn2 showed symptoms far too quickly (within 5 days) for the infection to have been chlam alone. And if I still have symptoms and my chlam culture is -, maybe the culprit is gonorrhea...
2) If gon was the problem a year ago, would the Levofloxacin I took have cleared it?
3) Would the Roxithromycin have worked for my partners in the case of gon?
4) If partn2 has had no symptoms 1 year later does it mean that maybe the gon has cleared out on its own (absolutely NO unprotected sex oral/vag/frottage)?
Thank you for your time!
5 Responses
300980 tn?1194929400
MEDICAL PROFESSIONAL
Welcome to the Forum.  I will try to address your questions but even before I do, I would say that with the questions you have, you would be well served to have another test for gonorrhea, chlamydia and other STDs.  This will provide definitive information as to what is, or is not, present.  With that as a starting point, let's work through your questions:

1.  Testing for gonorrhea has progress over the past 10 years.   Ten years ago a woman had to have a cervical swab test for gonorrhea and a man needed a swab taken from the penis.  Since then however new tests which are called nucleic acid amplification tests have become available (there are several brands). With these tests a urine specimen can be used to diagnose gonorrhea in men and women and for women a swab taken from the vagina without a speculum, by either the patient or the health care provider will actually diagnose gonorrhea and/or chlamydia more accurately than the older tests did. The same sorts of nucleic acid amplification tests can also be performed on swab specimens as well.

2 and 3. Both levofloxacin and roxithromycin are in the quinolone class of antibiotics and they cure most but not all cases of gonorrhea. There is geographic variation as to how common quinolone antibiotic resistance is around the world. My advice is that following therapy with either drug a repeat, "test of cure" test should be performed.

4.  Sadly, the symptoms of gonorrhea can go away without the infection being cured.  I would advise a repeat test.

Finally, I would point out that for women symptoms attributed to gonorrhea can also occur with other problems such as trichomonas or bacterial vaginosis.  These too can be diagnosed at the time of re-examination.

I hope these comments are helpful to you.  EWH
Avatar universal
Dr,
Thank you for your answer! It is helpful indeed.
OK,I've been surfing the Internet trying to educate myself on the subject and to better understand my test results. I think maybe I was wrong to say I was not tested for gonorrhea......
My last test, taken last week (as all of my previous ones) included- let me try and give an acurate translation from Greek- "vaginal secretion test for cocci, fungi, trichomonas- culture for aerobes, anaerobes, mycoplasma, ureoplasma and chlamydia".  It is my understanding that the bacterium that causes gonorrhea is a species of gram- diplococci. That falls under "cocci" in my test, right? My results show a list: Gram-coccobacteria/Gram+bacteria/Gram-diplococci/Gram+cocci. The only one marked is the gram+bacteria, where it says "plenty of lactobacilli". No clue cells, no fungi, no trichomonas. The test concludes "normal vaginal flora" The culture for mycoplasma,ureoplasma and chlamydia is negative as well.
What do you make of the above? Was I tested for gonorrhea or not? As I told you, all previous tests, including the ones that were positive for chlamydia, included exactly the same ...
So, if I was indeed tested for gon as well as chlam, and was found negative that would mean I'm on the clear. And if I never had gon in the first place I couldn't have passed it on to my partner and the treatment of Roxithromycin he received for chlamydia should be enough (no need to worry about a resistant strain of gon). I'm just thinking out loud here, please excuse me. I know I should just ask the testing centre, but I would very much welcome any more comments you may have on this.
Thank you again for answering, your expertise is greatly appreciated.
p.s. Have you ever been to Greece? If not, why not this year? I promise you, it's a beautiful place, the islands are magical in the summer! Be well!
300980 tn?1194929400
MEDICAL PROFESSIONAL
With all of this testing that you mention it would be most unlikely that you were not tested for gonorrhea.  If you have doubts, ask your doctor, don't just try to guess.  If you were tested for gonorrhea nd chlamydia and the tests were negative, then yes, you are in the clear.  

And yes, I have been to Greece and it is a wonderful place.  I look forward to visiting again.  EWH
Avatar universal
Thank you for commenting Doctor Hook!
I have already made an appointment with my gynecologist for next week and I am confident he will resolve any confusion regarding all my previous and last tests and also recommend additional testing for me or my partner, if needed.
Your comments have helped put my mind at ease and also prompted me to try and become better informed on this matter. For this I am greatful!
" Ef-charisto" (thank U in Greek)!
300980 tn?1194929400
MEDICAL PROFESSIONAL
Glad to help.  Take care.  EWH

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