Azithromycin For Gonorrhea And Chlamydia

In Both Males And Females

Complications that may be seen in anyone include:

• Other STIs. Chlamydia and gonorrhea both make you more susceptible to other STIs, including human immunodeficiency virus . Having chlamydia can also increase your risk of developing gonorrhea, and vice versa.
• Reactive arthritis . Also called Reiters syndrome, this condition results from an infection in your urinary tract or intestines. Symptoms of this condition cause pain, swelling, or tightness in your joints and eyes, and a variety of other symptoms.
• Infertility. Damage to reproductive organs or to sperm can make it more challenging or, in some cases, impossible to become pregnant or to impregnate your partner.

Can Amoxicillin Cure Std Super Infections

So far, weve been talking about the standard, run-of-the-mill case of STDs thats common in millions of people. Unfortunately, there is a new common threat. The World Health Organization recently reported that certain STDs, including gonorrhea, has been growing more resilient to the antibiotics weve been discussing, such as amoxicillin, which are usually used to eradicate it.

One of the likely causes of this advanced super gonorrhea is the fact that people often dont finish their antibiotics. Will Amoxicillin Cure Gonorrhea? Sure, most of the time. But you need to complete your medication, even if your symptoms seem to disappear. Stopping too early can allow bacteria to continue to grow and mutate. This can result in the infection coming back, or becoming far more dangerous.

This new super gonorrhea is much harder to stop. In some severe cases, it is incurable. Most bacteria will eventually evolve, developing resistances against specific antibiotics over time. Unfortunately, that includes amoxicillin. So while amoxicillin can currently usually treat gonorrhea, it will become less effective against strains of super gonorrhea in the future.

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What Is The Treatment For Gonorrhea

Gonorrhea can be cured with the right treatment. CDC recommends a single dose of 500 mg of intramuscular ceftriaxone. Alternative regimens are available when ceftriaxone cannot be used to treat urogenital or rectal gonorrhea. Although medication will stop the infection, it will not repair any permanent damage done by the disease. Antimicrobial resistance in gonorrhea is of increasing concern, and successful treatment of gonorrhea is becoming more difficult. A test-of-cure follow-up testing to be sure the infection was treated successfully is not needed for genital and rectal infections however, if a persons symptoms continue for more than a few days after receiving treatment, he or she should return to a health care provider to be reevaluated. A test-of-cure is needed 7-14 days after treatment for people who are treated for a throat infection. Because re-infection is common, men and women with gonorrhea should be retested three months after treatment of the initial infection, regardless of whether they believe that their sex partners were successfully treated.

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Drug Treatment Of Common Stds: Part I Herpes Syphilis Urethritis Chlamydia And Gonorrhea

CAROL WOODWARD, PHARM.D., West Virginia University Hospitals, Morgantown, West Virginia

MELANIE A. FISHER, M.D., M.SC., West Virginia University, Morgantown, West Virginia

Am Fam Physician. 1999 Oct 1 60:1387-1394.

This is Part I of a two-part article on drug treatment of common sexually transmitted diseases. Part II, Vaginal Infections, Pelvic Inflammatory Disease and Genital Warts, will appear in the next issue of AFP.

• References

Several advances have been made in the treatment of sexually transmitted diseases . These advances have been incorporated into the 1998 Guidelines for the Treatment of Sexually Transmitted Diseases, published by the Centers for Disease Control and Prevention .1

Highly effective single-dose oral therapies are now available for most common curable STDs. Single-dose regimens may be used for the treatment of chancroid, nongonococcal urethritis, uncomplicated gonococcal infections, bacterial vaginosis, trichomoniasis, candidal vaginitis and chlamydial infections.

Improved therapies are now available for the treatment of genital herpes and human papillomavirus infections. New regimens have been approved for the use of acyclovir in the treatment of genital herpes. In addition, two new antiviral agents, valacyclovir and famciclovir , have been labeled for the treatment of genital herpes. Patient-applied therapies are now recommended for management of HPV.

Preventing The Spread Of Gonorrhea

To minimize the risk of transmitting gonorrhea to others, avoid having sexual intercourse for at least seven days after completion of treatment. Also encourage any sexual partners from within the past 60 days to see their own doctors for evaluation.

If a person diagnosed with gonorrhea is in a romantic relationship, their partner should also get tested for gonorrhea. Its still possible to contract gonorrhea while being treated for gonorrhea.

If both partners are diagnosed with gonorrhea, their treatment will be the same. Both will need to abstain from sexual intercourse until theyve completed treatment and are cured.

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Amoxicillin For Chlamydia: Is It Effective

Amoxicillin is not the preferred treatment option for gonorrhea, but is it an effective way to treat chlamydia? The CDC reports that chlamydia can be easily treated with a course of antibiotics. But this does not mean that amoxicillin is effective simply because it is an antibiotic.

The CDC recommends that healthcare providers prescribe either azithromycin or doxycycline to treat chlamydia. The CDC also suggests several alternative antibiotics that can be used to treat chlamydia, including erythromycin, levofloxacin, or ofloxacin.

Amoxicillin is not on the list of antibiotics that the CDC recommends for the general treatment of chlamydia. However, it is on the list of antibiotics that the CDC recommends for the treatment of chlamydia in pregnant women. So if you are pregnant, your doctor may prescribe amoxicillin to treat chlamydia.

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Urogenital Infection In Women

• References

In women, chlamydial infection of the lower genital tract occurs in the endocervix. It can cause an odorless, mucoid vaginal discharge, typically with no external pruritus, although many women have minimal or no symptoms.2 An ascending infection can result in pelvic inflammatory disease .

Physical findings of urogenital chlamydial infection in women include cervicitis with a yellow or cloudy mucoid discharge from the os. The cervix tends to bleed easily when rubbed with a polyester swab or scraped with a spatula. Chlamydial infection cannot be distinguished from other urogenital infections by symptoms alone. Clinical microscopy and the amine test can be used to help differentiate chlamydial infection from other lower genital tract infections such as urinary tract infection, bacterial vaginosis, and trichomoniasis.3 In addition, chlamydial infection in the lower genital tract does not cause vaginitis thus, if vaginal findings are present, they usually indicate a different diagnosis or a coinfection.

Some women with C. trachomatis infection develop urethritis symptoms may consist of dysuria without frequency or urgency. A urethral discharge can be elicited by compressing the urethra during the pelvic examination. Urinalysis usually will show more than five white blood cells per high-powered field, but urethral cultures generally are negative.

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Doxycycline Vs Azithromycin: Think Twice About The 2020 Cdc Guideline Update On Treatment Of Gonorrhea And Chlamydia

When the new Centers for Disease Control and Prevention recommendations1 regarding the treatment of uncomplicated gonorrhea debuted like a slice of antibiotic resistance doom, it felt like another gift had arrived from 2020. Intramuscular ceftriaxone dosing has increased from 250 mg to 500 mg . Empiric chlamydia coverage switched from a single dose of 1 g of azithromycin to doxycycline 100 mg PO BID for 7 days. Being deferential to CDC expertise, many providers accepted them uncritically. Compliance rates with a switch from a 1-time to a 7-day regimen are not addressed, especially worrisome for a condition that can be minimally or asymptomatic.

How Common Are These Stds In General How Common Are The Antibiotic

The CDC estimates there are 820,000 cases of gonorrhea in the United States each year. Klausner says that less than 1% fail to respond to the currently recommended treatment. However, he says, resistance to older, less expensive antibiotics is much higher.

Chlamydia is the most common STD in the United States, with nearly 3 million cases occurring annually. So far, no treatment-resistant cases have been reported.

In 2019, nearly 130,000 cases of syphilis were reported in the U.S., with the most infectious types increasing 11% from 2018 to 2019, according to CDC statistics.

The numbers for these three STDs, which are the most common, are at a record high, according to the CDC.

âWeâre absolutely seeing an increase in overall rates of STDs, particularly in younger patients,â says Englund. âHalf of cases are diagnosed in patients aged 15 to 24.â

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How Is Each Condition Transmitted

Both STIs are caused by bacterial infections that are transmitted through unprotected sexual contact, meaning sex without using a condom, dental dam, or another protective barrier between you and your partner during vaginal, anal, or oral sex.

Its also possible to contract the infection through sexual contact that doesnt involve penetration. For example, if your genitals come into contact with the genitals of someone whos contracted the infection, its possible to develop the condition.

Both STIs can also be contracted through protected sex with a condom or other barrier if you dont use protection properly, or if the barrier breaks.

Either STI can be contracted even if you arent showing visible symptoms. Both STIs can also be transmitted to a child at birth if the mother has either condition.

Youre at increased risk for developing these and other STIs if you:

• have multiple sexual partners at one time
• dont properly use protection, such as condoms, female condoms, or dental dams
• regularly use douches which can irritate your vagina, killing healthy vaginal bacteria
• have contracted an STI before

Sexual assault can also increase your risk of both chlamydia or gonorrhea.

Both STIs can be diagnosed using similar diagnostic methods. Your doctor may use one or more of these tests to ensure that the diagnosis is accurate and that the right treatment is given:

Chlamydia Antibiotics: Azithromycin Vs Doxycline

A test was conducted on data between 1975 and 2001 to find and compare the efficacy and differences between Azithromycin and Doxycycline. The patients were randomly given dosages of either Azithromycin or Doxycycline in the prescribed quantities of one 1g dosage of Azithroymycin and two dosages of 100mg twice a day for a week with no patient getting both. The tests were conducted on 1543 patients for checking the microbial efficacy of the drugs and on 1717 patients for checking any adverse effects of the drug. Cure rates of about 98% were found out for both the Chlamydia Antibiotics proving the efficacy of both as equally compelling.

However, azithromycin is more convinent as it is just 1 dose antibiotic. Overall one dosage of Azithromycin has proved to be very impactful in comparison to the multiple dosages of Doxycycline.

Signs & Symptoms

Chlamydia is known to be a silent or asymptomatic disease and about 50% of infected men and 60% of infected women dont show any signs or symptoms initially.

Women are prone to be more asymptomatic than men. This means women generally show no symptoms and act as carriers of the diseases.

However women are at greater risk from long term complications and hence it is important to get treated.

Chlamydia in Women

Chlamydia in Men

Again 25-50% men show little or no symptoms. Symptoms when they show up include painful urination, discharge from the tip of the penis and testicular inflammation and pain.

References:

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Why No Mention Of The Single

The evidence basis for the change to doxycycline for treatment of chlamydia co-infection coverage is substantially weaker. It is also decidedly mute on the risks of partial or non-compliance with treatment. The question then becomes: How profound is the treatment effect and how does it balance against its risks?

The guideline states, as evidence for the doxycycline switch:

A recent investigation comparing children who received twice-yearly azithromycin with children who received placebo found that the guts resistome, a reservoir of antimicrobial resistance genes in the body, had increased determinants of macrolide and nonmacrolide resistance, including beta-lactam antibiotics, among children receiving azithromycin .3 A higher proportion of macrolide resistance in nasopharyngeal Streptococcus pneumoniae was demonstrated in communities receiving mass administration of oral azithromycin .4 Azithromycin resistance has been demonstrated in another STI, Mycoplasma genitalium, and sexually transmissible enteric pathogens 5-7. In addition, evidence supports increasing concern for the efficacy of azithromycin to treat chlamydial infections, especially rectal infections 8,9.

That really leaves the meta-analysis8 to answer our question: how best do we protect the reproductive health of our patients in the setting of diagnostic uncertainty?

Who New Treatment Guidelines For Gonorrhea Chlamydia And Syphilis

The World Health Organization on 30th Aug released new therapy guidelines for 3 sexually transmitted infections , stating the updates respond to an urgent need in light of improving antimicrobial resistance.

Ian Askew, director of reproductive health and research at WHO said,

Chlamydia, gonorrhoea and syphilis are main public health issues globally, impacting large numbers of peoples quality lifestyle, causing severe illness and often death. The new WHO guidelines strengthen the need to treat these STIs with the appropriate antibiotic, at the appropriate dose, and the right time to decrease their spread and enhance sexual and reproductive health.

With respect to WHO, the 3 bacteria cause over 200 million infections every year, and increasing resistance has made them more complicated or impossible to treat with current antibiotics. Of the 3 infections, WHO states that, gonorrhea is the very challenging to treat, with some strains now resistant to all accessible antibiotics.

When drawing the guidelines, WHO states it looked for therapies that provided high efficacy and quality while paying attention to cost, toxicity, route of administration, along with the likelihood for resistance to the therapies developing.

Furthermore to revamping its therapy recommendations, WHO says that individual health systems should boost surveillance for the infections, and urges nations to quickly follow the new guidelines.

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Whats The Treatment For Gonorrhea

Gonorrhea is usually super easy to get rid of. Your nurse or doctor will prescribe antibiotics to treat the infection. Some strains of gonorrhea resist the antibiotics and are hard to treat, so your doctor may give you two antibiotics, in shot and pill form. Sometimes you only have to take one pill. Other gonorrhea pill treatments are taken for 7 days. Your doctor will help you figure out which treatment is best for you.

If youre treated for gonorrhea, its really important for your sexual partners to get treated also. Otherwise, you may pass the infection back and forth, or to other people. Sometimes your doctor will give you medicine for both you and your partner.

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Frequently Asked Questionsexpand All

• What is a sexually transmitted infection ?

  A sexually transmitted infection is an infection spread by sexual contact. There are many STIs. This FAQ focuses on chlamydia, gonorrhea, and syphilis. These STIs can cause long-term health problems and problems during pregnancy. Having an STI also increases the risk of getting human immunodeficiency virus if you are exposed to it.

• What is chlamydia?

  Chlamydia is the most commonly reported STI in the United States. Chlamydia is caused by a type of bacteria, which can be passed from person to person during vaginal sex, oral sex, or anal sex. Infections can occur in the mouth, reproductive organs, urethra, and rectum. In women, the most common place for infection is the cervix .

• What are the risk factors for chlamydia?

  The following factors increase the risk of getting chlamydia:

• Having a new sex partner

• Having more than one sex partner

• Having a sex partner who has more than one sex partner

• Having sex with someone who has an STI

• Having an STI now or in the past

• Not using condoms consistently when not in a mutually monogamous relationship

• Exchanging sex for money or drugs

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Chlamydia: Symptoms & Treatment Options

This is one of the most common sexually transmitted diseases. Although its curable, people who are infected with it become more likely to contract HIV.

Symptoms: Most people who have chlamydia arent aware of it, because it rarely has any symptoms. However, the people who have reported symptoms have complained about painful sexual intercourse, unusual discharge from their genitals, and burning while urinating

Treatment: Chlamydia can also be cured with antibiotics.

Diseases Characterized By Urethritis And Cervicitis

IM = intramuscularly.

Reprinted from Centers for Disease Control and Prevention. 1998 Guidelines for the treatment of sexually transmitted diseases. MMWR Morb Mortal Wkly Rep 1998 47:1111.

*Mucopurulent cervicitis should be treated according to the guidelines for chlamydial and gonococcal infections.

Estimated cost to the pharmacist based on average wholesale prices in Red book. Montvale, N.J.: Medical Economics Data, 1999. Cost to the patient will be higher, depending on prescription filling fee.

Several regimens for the management of patients with nongonococcal urethritis are outlined in Table 2. Oral azithromycin is recommended as single-dose therapy.57 Improved compliance and the ability to observe therapy are advantages associated with single-dose regimens.

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What Can Be Done To Address The Problem

Klausner says a three-way approach is needed:

• Control the spread of new infections through prevention, screening, and treatment. However, there is much less funding for such efforts. The CDC says that more than half of state and local STD programs have seen budget cuts in years. âThe money taken out of budgets absolutely correlates with the increases in cases of STDs that weâre seeing,â Englund says.
• Develop new antibiotics. Thereâs good news here: A new antibiotic now being tested has shown promising results in recent trials. When and if it will be effective and enter the market is unknown.
• Develop tests to identify the best treatments. Klausnerâs lab has developed a test, now in use at UCLA Health System, that can tell physicians which antibiotic a particular case of gonorrhea will respond to. This has allowed them to successfully treat many cases of gonorrhea with older, less expensive antibiotics.

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