[Question #8494] STD Possible Infection/Medication
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43 months ago
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Hi, I'm a man who had unprotected sex 2 days ago. The woman after the fact informed me she had an STD. I did a telehealth apt and they prescribed me a couple of pills to cure the common STDS. My concern is if I'm taking the medicine too quickly after the act. Will it still work even if I show no symptoms and I'm getting ahead of it being it's only been 2 days? I don't know the normal incubation period but I just don't want to take the pills when they won't be effective. Will they prevent and STD from forming? Thank you!
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H. Hunter Handsfield, MD
43 months ago
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Welcome to the forum. Thanks for your confidence in our services.
I'll try to help, but there's so much missing information here! Which STD does she have? What was/were the exact exposure(s)?: vaginal sex? anal? oral by either of you to the other? What medication were you given? A single dose of "a couple of pills" suggests azithromycin, which is reliably effective only against chlamydia: but people exposed to chlamydia are supposed to also be treated for gonorrhea, which usually requires an injection of ceftriaxone, or at least oral medication in addition to azithromycin.
If we're dealing with chlamydia, and if you received azithromycin, it will be effective: there is no such thing as being treated too soon. You weren't necessarily infected: with a single vaginal sex event with an infected female, the chance a male will catch it is under 50%. But if you were exposed and infected, azithromycin will take care of the problem.
Also, anyone exposed to chlamydia or any other STD is suppsed to be tested for that and for other STDs, before treatment -- but apparently that wasn't done either?
What was the source of your telehealth appointment? (I don't want the provider's name, but perhaps the clinic or practice. It would also be helpful to know where this occurred: US? Other country? If in the US, what city and state?
I'll be happy to comment futher if you'd like to fill in all the gaps! In the meantime, I hope this has been helpful.
HHH, MD
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43 months ago
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Hi, sorry for the lack of info, it was oral/vaginal sex and the STD in question is chlamydia. I'm in the US it was the mdlive app. I just stated my concerns and they basically said they'll go with the assumption that I contacted it as far as treatment. I was given the following: Azithromycin 500 MG Oral Tablet (2 by mouth 1 time) Cefixime 400 MG Oral Capsule (2 by mouth 1 time) <---1st day. Metronidazole (metroNIDAZOLE) 500 MG Oral Tablet (4 by mouth) on day 2. I haven't taken these yet they're sitting on my counter. I'm currently taking Amoxicillin 875 twice a day for strep. Will I be able to also take these medicines or do I have to wait for my 10 day course of amoxicillin to end? Thank you
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H. Hunter Handsfield, MD
43 months ago
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OK, thanks for the additional information. It helps a lot -- including confidence that the Telehealth provider you saw understands STDs and their treatment.
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You were treated appropriately for the most part: azithromycin 1 g (1000 mg) for chlamydia plus cefixime 800 mg in case gonorrhea also was present -- exactly according to standard guidelines (when ceftriaxone cannot be given by injection). The metronidazole advice was in case you also were exposed to trichomonas, but that's unlikely and such treatment usually isn't included in this situation. No harm done, but not generally recommended. So for sure take the azithromycin and cefixime, but I would say you really needn't take the metronidazole.
If you were taking amoxicillin at the time you were exposed, it somewhat reduced the chance you were infected with either gonorrhea or chlamydia, but in itself was not reliable against either one. However, it doesn't affect your STD treatment one way or the other; and the cefixime and azithromycin also are active against strep. To reduce the risk of stomach upset, you could skip the next two doses of amoxicillin as you take the STD drugs, then resume it a day later. Or check with the doctor who prescribed your strep treatment to assure s/he agrees.
It sounds like arrangements weren't made to test you for gonorrhea or chlamydia before treatment. However, even if you caught them, testing probably would be negative because of the amoxicillin. So no big deal.
Final thought: Is it clear that your partner with chlamydia had it before you/ -- i.e. that you were exposed, but not likely the source of her infection? If you might have been the source, you should speak with any other sex partners you've had in the past month and make sure they are aware and get tested and perhaps treated.
I hope this information is helpful. Let me know if anything isn't clear.
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