Gonorrhea Recurrence: Symptoms, Treatment, and Recovery

Gonorrhea recurrence

Hello doctor, on March 10, I was diagnosed with urethritis, but I was unsure whether it was caused by gonorrhea or chlamydia.
The clinic doctor prescribed me tetracycline antibiotics, which I took for a total of two weeks, and the symptoms disappeared, and I no longer experienced pain while urinating.
Later, the doctor said I didn't need to come back.
However, on March 31, I noticed yellow discharge from the glans.
From March 10 to March 31, I did not engage in any high-risk behaviors or sexual intercourse, but I did stay up late and drink alcohol.
I then went to a urology department at a large hospital for an examination, and the doctor said it was likely chlamydia causing the urethritis, so he prescribed me azithromycin antibiotics for five days.
The doctor said if there are no symptoms after five days, I wouldn't need to return for a follow-up.

I have a few questions:
1.
Is this a recurrence of gonorrhea? Why was the tetracycline antibiotic ineffective? Will the azithromycin antibiotic be effective?
2.
Will the bacteria develop antibiotic resistance?
3.
If there are no symptoms after five days, can I be certain that I have recovered? Does that mean all the bacteria are eliminated and there won't be a recurrence, or do I need to undergo further testing?

Xiao Jiu, 30~39 year old female. Ask Date: 2016/04/01

Dr. Li Xinyi reply Urology

I am not aware of any of the results you checked.
Therefore, I cannot provide any recommendations.
It is advisable to continue visiting the original major hospital's urology department for further examination and to discuss with the physician.

Reply Date: 2016/04/01

More Info

Gonorrhea, caused by the bacterium Neisseria gonorrhoeae, is a sexually transmitted infection (STI) that can lead to various complications if left untreated. Your experience with urethritis and the subsequent treatment raises several important questions regarding the recurrence of symptoms and the efficacy of antibiotics used in treatment.

1. Is this a recurrence of gonorrhea? Why was tetracycline ineffective? Will the new antibiotic work?
It’s important to clarify that tetracycline is not the first-line treatment for gonorrhea. The Centers for Disease Control and Prevention (CDC) currently recommends dual therapy for gonorrhea, typically involving ceftriaxone and azithromycin. Tetracycline may not be effective against gonorrhea due to the development of antibiotic resistance. If your symptoms returned after treatment with tetracycline, it is possible that the initial infection was not adequately treated, or you may have been re-exposed to the bacteria.

The new antibiotic, Doxycycline (日舒錠), is often used to treat chlamydia infections, which can co-occur with gonorrhea. If your urethritis is indeed caused by Chlamydia trachomatis, Doxycycline should be effective. However, if the infection is due to gonorrhea, it may not be sufficient on its own. It is crucial to follow your healthcare provider's instructions and complete the full course of antibiotics.

2. Will the bacteria develop resistance?
Antibiotic resistance is a significant concern in the treatment of STIs, including gonorrhea. The overuse and misuse of antibiotics can lead to the development of resistant strains of bacteria. If you have been treated with tetracycline and it was ineffective, it raises the possibility of resistance. This is why it is essential to use the recommended first-line treatments for gonorrhea and to avoid self-medicating or using antibiotics without proper medical guidance.

3. If symptoms resolve after five days, does that confirm recovery? Will the bacteria be eradicated, or should I get tested again?
While the resolution of symptoms is a positive sign, it does not necessarily confirm that the infection has been completely eradicated. Symptoms can sometimes improve even if the infection persists. It is advisable to follow up with your healthcare provider after completing the course of antibiotics, especially if you have had a history of recurrent infections. A follow-up test, often referred to as a test of cure, may be recommended to ensure that the infection has been fully treated.

In summary, it is crucial to adhere to the prescribed treatment regimen and to communicate openly with your healthcare provider about any concerns or recurring symptoms. If you experience any new or worsening symptoms, or if you have any questions about your treatment, do not hesitate to seek medical advice. Additionally, practicing safe sex and getting regular STI screenings can help prevent future infections and complications.

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