just wondering...

[franko12]

Hello Dr.

I just want to confirm the following:

I, and my GF were prescribed 1g of azithromycin and 400mg of cefixime (i think that was the grammage of cefixime).

The azithro was taken in four 250 mg pills all at the one time followed by the cefixime straight away.

Would this have reliably killed clym. or gon had it been present?

I saw this post:

http://www.medhelp.org/posts/STDs/Post-Docking-Burning-in-urethra/show/1666218

In it Dr. Hook states:

"In fact, the studies show that the 1.0 gram dose of azithromycin is more effective for chlamydia than taking the 500 mg dose followed by 250 dose pills."


1.  I just wanted to know whether in the post, this meant 500mg at first, followed by 250mg per day for 4 days.
2.  and also whether, the 1 g that Dr. Hook was referring to, was  either a single pill of 1g, or the 1g could be made up of 4x250mg pills. I.e. there is no difference between 1 single 1 gram pill, or 4 250mg pills in terms of efficacy.


I hope i make sense, if I have not please just tell me.

[Edward W Hook, MD]

You are not being very trusting and appear to be overly anxious about this.  Uou have both been tested with no evidence of infection  and, apparently despite that, treated.  Now you are second guessing your doctor who sounds right on target.  Testing for gonorrhea is now almost uniformly done with PCR type tests which do not need gel transmport medium.  Believe the result.

this will conclude this thread.  EWH

[franko12]

And I am sorry but lastly, the actual swab that was used, appeared to be just a standard swab and after he swabbed it he placed it in the clear tube. and then sealed the tube.

I noticed however there was no gel in the tube - I had my throat swabbed for tonsillitis once and the swab was put into a tube which had a gel and when I asked that Dr. he said it was for the bacteria to grow.

There was however no gel in the tube for the throat swab for clym and gon - is that because the test is carried out by PCR? and the lab technicians are looking for dead bacteria as opposed to growing the bacteria?

Best Wishes

[Edward W Hook, MD]

Correct.  EWH

[franko12]

thank you Dr. yes the dr did, I remember feeling it.
last queston:

My private dr said that the bacteria would be all over my mouth and throat, so would be easily detected even if the dr didn't not get right to the back of the throat, and touched say the back of my mouth, roof of mouth, back of tongue then it would be a reliable test.

correct?

[Edward W Hook, MD]

If the doctor touched yor throat withthe swab, your test was fine.  time to stop worrying.  EWH

[franko12]

Thank you Dr.

Lastly, perhaps you can just answer this: I had my throat swabbed for ghonorrea and clymdia and was worried that the Dr. may not have adequately swabbed my throat.

Am I right to say that, even if the Dr. didn't get right to the back of my throat (i have had a bad gag reflex), but picked up saliva, as well as swabbing part of my mouth and throat just not right to the back of my throat , then because the tests are so sensitive had there been bacteria, it would have been detected?

The Dr said he did get a sample, I just worry and know i can always trust your expertise.

thanks for your quick responses.

[Edward W Hook, MD]

No, the order in which the pills are taken would make no difference.  You are fine. EWH

[franko12]

So Just to clear things up and make it simple off of one post:

We took the azithro 250mg pills one directly after the other with maybe a 15 second gap between pills and took the 400 mg of cefixime either directly before the azithromycin or directly after it - waiting maybe a couple of minutes (maximum) after taking the azithromycin or or taking the 400 mf of cefixime and then waiting a couple of minutes maximum before taking the azithromycin.

sorry for being clumsy. hope this is easier for you

[franko12]

We took the four pills at the same time, one directly after the other.

[franko12]

Haha thank you Dr.

I was worried when you said 1gram dose as I thought that related to a single pill. So 4x250mg is suffice then.

I also took the 400mg of cefixime as well. Either immediately before it or after it. Does that make a difference at all, or can the antibiotics be taken immediately before or after with no issues?

Thank Dr.

[Edward W Hook, MD]

Welcome to the Forum.  Perhaps I wasn't clear.  Treatment with cefixime 400 mg (you did get the dose correct) plus 1.0 gram of azithromycin as a single dose is the CDC recommended therapy for gonorrhea and would reliable cure chlamydia as well.  To my knowledge there are no 1.0 gram azithromycin pills and if there were it would be like swallowing a large marble (ugh!!!).  All four of the azithromycin pills should be taken at about the same time.  

does this clear things up?  EWH

[franko12]

Regarding question 2, I meant to say that there is no difference between 1 single 1gram pill or 4x250mg pills where the four pills are taken ALL AT THE SAME TIME in terms of efficacy.