[Question #9815] Doxycycline vs Azithromycin
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28 months ago
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Hello doctor. I posted in the last few about an exposure I had. Dr Hook was mistaken on how soon it should be closed as he forgot to submit a reply. My exposure was 3/23/2023.
I am currently taking doxycycline 100 mg twice a day and got a rocephin shot 500 mg two days ago things have definitely improved over the last few days. I never had any discharge or anything but had testicle pain and probable epididymitis.
I have read that Azithronycin combined with rocephin is the preferred choice.
1)Is there a success rate difference on the Doxycycline 100 md bid vs azithromycin 1g given once?
2) would it be advisable now to stop the doxycycline and just use one dose of azithromycin. The injection was given on Monday and I started the doxycycline last Friday
3) is there a resistance issue with doxycycline if taken correctly and used with the rocephin?
4) what is easier through Myson or Doxy cycling given for when combined with the rocephin? Gonorrhea, syphilis, or chlamydia?
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28 months ago
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4) this was supposed to say what is the reason for giving azithromycin or doxycycline with the rocephin? Is it chlamydia, gonorrhea, or syphilis as that reason?
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Edward W. Hook M.D.
28 months ago
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You are mistaken. If you open the thread that I closed yesterday evening you will find the you received three responses which is the number of replies that we provide to each client.
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Your questions are becoming repetitive and indicate that you are troubled by unwarranted anxiety. repeating questions will not change the answers. If you do not respond to this note in the next few hours, I will ask that your posting fee for this question be reversed. If you reply, particularly with additional repetitive, anxiety-driven questions, the charge will remain in place however, at the end of this thread, after it is closed, should you return with further questions on this encounter, you're future questions may be closed without a response and without return of your fee. EWH
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28 months ago
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Thank you.
I guess the main questions I have are
1) is there any benefit of azithromycin over doxycycline?
2)would there be any problem with me taking 1 gram of Azithromycin and staying on the week course of doxycycline?
3)any benefit of taking both in regards to treatment success?
Thank you..that’s all.
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28 months ago
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Thank you.
I guess the main questions I have are
1) is there any benefit of azithromycin over doxycycline?
2)would there be any problem/harm with me taking 1 gram of Azithromycin and staying on the week course of doxycycline?
3)any benefit of taking both in regards to treatment success?
Thank you..that’s all.
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Edward W. Hook M.D.
28 months ago
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Recommendations for azithromycin over doxycycline are out of date. Doxycycline is preferred over azithromycin for STI treatment as the result of clinical trials which showed doxycycline to be more effective.
Taking both azithromycin and doxycycline would not cause harm other than possible side effects. There are no data on any benefits from taking both medications and no logical reason why the combination would work better than just doxycycline.
You have 1 follow-up remaining. EWH
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28 months ago
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I do see where I am taking the CDC recommendations(doxy>zith) Hopefully if I do have either, this regimen will cure it.
1)I’m better since Monday(rocephin), but still have epidi pain. How long does it take for symptoms last orto go away with gon/chlamydia?
2) should I still be concerned I still have pain?
3) how long does rocephin continue to work after the shot?
4)based on symptoms, if it were an STD, what would you think I’d more likely to have?
5) is it ever practice to repeat the treatment I have had without testing but having symptoms persist?
6) I was tested on Monday and should have the results early next week. Can you leave this post open so I can post them to you? I won’t reply or ask anything else in between.
Thank you
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28 months ago
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I do see where I am taking the CDC recommendations(doxy>zith) Hopefully if I do have either, this regimen will cure it.
1)I’m better since Monday(rocephin), but still have epidi pain. How long does it take for symptoms last orto go away with gon/chlamydia?
2) should I still be concerned I still have pain?
3) how long does rocephin continue to work after the shot?
4)based on symptoms, if it were an STD, what would you think I’d more likely to have?
5) is it ever practice to repeat the treatment I have had without testing but having symptoms persist?
6)when you are rx’d azithromycin/or doxycycline with rocephin, is that for gonorrhrea, chlamydia, or syphilis?
7)I was tested on Monday and should have the results early next week. Can you leave this post open so I can post them to you? I won’t reply or ask anything else in between.
Thank you
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Edward W. Hook M.D.
28 months ago
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You need to be more patient. The Forum is not staffed 24/7. Questions are answered within 24 hours posting on most occasions, often sooner.
These will be my final responses. Your questions regarding your virtually NO RISK encounter are repetitive and reflect your anxiety. Should you post further, the thread will be closed without a response.
1)I’m better since Monday(rocephin), but still have epidi pain. How long does it take for symptoms last orto go away with gon/chlamydia?
This is a repetitive question. The onset of your testicular discomfort was too soon to be due to an STI acquired in the encounter you have described. It's persistence without improvement despite treatment likewise would be unusual for STI related epididymitis. At this time you should seek evaluation of your discomfort by a trained clincian if you have not already.
2) should I still be concerned I still have pain?
See my comment above. Testicular discomfort may or may not reflect a patholocial process. You should be examined by a knowledgeable clincian who has heard your entire history.
3) how long does rocephin continue to work after the shot?
A single injection of Rocephin is adequate treatment for the STIs you are concerned about. Additional treatment would be a further waste of time and resources.
4)based on symptoms, if it were an STD, what would you think I’d more likely to have?
Your symptoms are not consistent withan STI. Playing the "what if" and "what could this be" game is a waste of time and energy. See a trained clinician!!!
5) is it ever practice to repeat the treatment I have had without testing but having symptoms persist?
No, not without careful evaluation and testing by a trained clinician.
6)when you are rx’d azithromycin/or doxycycline with rocephin, is that for gonorrhrea, chlamydia, or syphilis?
The treatment would cure gonorrhea and chlamydia and prevent syphilis as explained in the past.
7)I was tested on Monday and should have the results early next week. Can you leave this post open so I can post them to you? I won’t reply or ask anything else in between.
I will leave the thread open so you can post your results. If you post further questions, they will not be answered.
EWH
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28 months ago
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Hello Dr Hook. I got my results back today which were 3 1/2 days after the exposure. All tests negative. I’m not sure how reliable they are as I may have tested too soon according to some sources online. My symptoms have eased a bit after switching from doxycycline monohydrate doxycycline hyclate. I see my doctor tomorrow. A few last questions
1) how soon is RELIABLE testing for gonorrhea/chlamydia?
2)are my tests any value?
3)window period for std tests?
4)I will consult my doctor, but will it be advisable to test now for gonorrhea/chlamydia and if negative, would it be a true negative?
Thank you for your patience
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Edward W. Hook M.D.
28 months ago
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Thanks for the follow-up information. I can't say I'm surprised given the no risk nature of your encounter. In final response to your extra (since you have already had 3 responses)questions:
1) how soon is RELIABLE testing for gonorrhea/chlamydia?
Testing for gonorrhea and chlamydia is reliable 3-5 days after an encounter. In your case, that you were already taking antibiotics may reduce the accuracy of testing. How much is unclear.
2)are my tests any value?
You did not need testing to start with. Since you were taking antibiotics at the time of testing, the results are not entirely conclusive.
3)window period for std tests?
See response to question no. 1.
4)I will consult my doctor, but will it be advisable to test now for gonorrhea/chlamydia and if negative, would it be a true negative?
Testing 3-5 days AFTER completion of antibiotics will be reliable and, I'm confident, will again show that you were not infected.
This completes this thread. If you return with further anxiety driven, repetitive questions about the encounter that you have been told repeatedly did NOT put you at risk for any STI, the question may be closed without a response and without return of your posting fee. You need to move on. EWH
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