[Question #2968] STD treatment

39 months ago
Hi doctors just want to start my question by saying thank you for this great service. So here's my story over the past two years I've had 8 episodes of unprotected oral and 3 episodes of protected vaginal sex and  one case of protected sex but after a minute I thought I saw a tear in the condom so it might be one case of unprotected  vaginal sex my last exposure being around 8 month before I met my girlfriend. Since I'm getting married next week I decided to go to my doctor to see about my std risks I wasn't worried about hiv since that was the only thing I was previously worried about and have tested negative repeatedly. But I was worried about other stds like gonorhea and syphilis he told me it was unlikely that I'm infected with anything based on my risks especially syphilis but he gave me 2g of azithromycin as a single dosage and told me that would take care of anything even syphilis he told me even though penicillin is the preferred treatment of syphilis the azithromycin would take care of that too he said something about there being a azithromycin resistant strain of syphilis but that's only common is gay men. It sounded like he knew what he's talking about but I'm asking the experts would this medicine and this dosage take care of any std I might have caught in the past two years? I'm specifically worried about syphilis since it's not the preferred antibiotic. Thank you!
39 months ago
I've also since read that this medicine might cause heart problems is this for extended usage or even a single course?
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
Welcome to the Forum. I'll be glad to comment.  Let me start by complementing your decision to practice safe sex.  Overall, your exposures were low risk for acquisition of any STI despite the fact that your condom may have failed on one occasion. 

I wish your doctor has chosen to test you.  In general it is preferable to test and then, should an STI be present, treat it than to treat persons "just in case".  But, we cannot undo what has been done.  Azithromycin is good therapy for most STIs and the dose of medicine you took would have cured chlamydia, most gonorrhea and much but not all syphilis.  Since it is unlikely that you were infected to start with, at this point I would not worry further.  Should you feel the need to test, I would suggest you wait at least two week before testing for gonorrhea and chlamydia.  You can test for syphilis at any time and expect reliable results. 

You are correct that, in very rare occasions, azithromycin, like many other medications can cause disturbances in the heart rhythm.  When the side effect occurs, it is typically in persons who are taking multiple doses of the medication.  Since you have taken the medication without problems, I would not worry about medication side effects at this time. 

I hope this information is helpful to you.  EWH
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39 months ago
Thanks for your clear and detailed answer. Just have one more question I know its unlikely but if I did have something and the medicine took care of it how long do I have to wait to have sex is a week enough?
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
Yes, in the unlikely event that you were infected, it would be safe to resume sex a week after taking effective antibiotics.  EWH---
39 months ago
Would the same apply for syphilis as well I know that a week is recommended for other std what about syphilis? Thank you.
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
In formal studies of syphilis treatment, 2 grams of azithromycin was effective for Syphilis treatment.  More recently their have been concerns about azithromycin resistance but in your case, given the absence of evidence of Syphilis I would not worry.  EWH---
39 months ago
Thanks. When you say absence of evidence do you mean no sore and no rash because I do not remember getting any suspicious rashes in the last two years. I'm just wondering since my first exposure was more then two years ago is it possible if I did have syphilis would it become nerousyphilis and would the other antibiotic cure it or is only penicillin effective? I know it's probably just my health anxiety and anxiety about getting married but in your medical opinion do I need to worry about it?
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
Correct, if you had syphilis, you would have had a penile sore and most likely would have noticed.m there is just no reason to worry about neurosyphilis.  You need to relax.

As you may know, we provide up to three responses to questions.  This is my 4th.  Thus this thread will be closed shortly.  Take care.  EWH
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