[Question #13576] Dosage
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1 months ago
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Hello I had a quick question regarding preventative syphilis treatment. Is a 500mg injection of ceftriaxone sodium administered to the glutes enough to take care of incubating syphilis? I did not want to pay for penicillin and had a recent risky exposure as of 14 days ago.
Also for future reference is using protection and not seeing any visual chancres during an event a reasonable indication that there was minimal risk?
I realize I got reloaded the order oage due to a wifi disconnect and got two questions when I ordered last. Figured I would use this one as well.
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Edward W. Hook M.D.
1 months ago
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I'm troubled that you are having so much trouble moving forward following the close to no risk encounter that you have returned to the Forum about repeatedly. A 500 mg injection of ceftriaxone would prevent development of incubating syphilis.
You really need to move on. EWH
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1 months ago
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My apologies doctor I do not mean to waste your time. I am working with a therapist towards getting past what I can assume is the nervousness due to guilt of stepping out on my significant other.
Gonorrhea and Chlamydia I can ease myself as they are short term periods before obvious symptoms show, but in my nervousness syphilis and the 6 week period before a test is accurate give me unease. Even with the protective measures Ive taken and your guidance.
The reason I asked this question is that the doctor that prescribed me the shot mentioned that the US guidelines are 1g daily for up to 10 days and seemed to be adamant that the 500mg alone would not clear any syphilis as 500mg is the dosage for gonorrhea. However based on your past response I got the singular 500mg dosage. Is there any difference in efficiency in treatment between the daily regimen or is that based on the assumption that I am fully past incubation.
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Edward W. Hook M.D.
1 months ago
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Taking unnecessary treatment is not going to do anything but sustain your unwarranted anxiety. Syphilis is a relatively uncommon STI and you are not at meaningful risk. You might discuss this with your therapist.
There is a difference between the dose of antibiotics required to prevent incubating infection and to treat established infection. There is no evidence that you have either. EWH
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1 months ago
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Last question Dr, due to the antibiotics (500 mg ceftriaxone) on top of the already low risk of syphilis, I have gotten myself past the concern that that is a reasonable risk. I will still check myself and most likely get a blood test at six weeks as it is time for my yearly checkup anyway but will not abstain from sex with my significant other so long as no chancres show.
I had a question about Gonorrhea/Chlamydia and HPV from the unprotected oral. It has now been almost 3 weeks since the exposure (3 weeks tomorrow) and I have not had any of the common and noticeable symptoms of either gonorrhea and Chlamydia. I took a urine test last week however they seem to have had a misunderstanding and didn’t actually send it to the lab. They asked if I wanted to come back but will be charging another visit fee. Due to not wanting to spend the extra money out of pocket and the fact its been 3 weeks with no symptoms I feel like I am pretty in the clear for both Gonorrhea and Chlamydia from the unprotected oral.
In your opinion is absence of symptoms at 21 days after exposure evidence enough that I am clear of risk? On top of the other reasons we have discussed many times on this forum (escorts being tested regularly, oral being rather low risk due to no high prevalence of oral gonorrhea, and the fact that 99% of cases show symptoms?)
I am very open with my therapist as he is trying to help me through my issues with partaking in these risky issues and he briefly mentioned HPV. I wanted to know if HPV from unprotected Oral is a reasonable possibility? From my understanding HPV is pretty common and I have even gotten the series of 3 immunizations back in 2014.
Is there any reason whatsoever to be concerned about HPV?
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Edward W. Hook M.D.
1 months ago
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Final responses:
Over 90% of persons with penile gonorrhea and about 60% persons with chlamydia develop symptoms. Symptoms develop within 10 days of an exposure. As you already know, you are overall risk of infection is quite low, but testing is always a personal choice.
The topic of HPV is complex. I see a little reason for you to worry about HPV given the nature of your exposure and your vaccination status however, to learn more about HPV risk please feel free to look at other threads on this forum on the topic.
As you know, we provide up to three responses to each clients questions. This is my third response and the thread will be closed now. There should be no need to return. Please work with your therapist. EWH.
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