Gonorrhea and Chlamydia Treatment: A Patient's Journey

Q: Gonorrhea and Chlamydia Treatment: A Patient's Journey

Hello： The treatment for gonorrhea follows certain guidelines, which can be referenced. <br>It is recommended to use doxycycline for 14 days; however, in some cases, issues may arise due to antibiotic resistance or non-compliance with the medication regimen, and there is no guara

The issue of eradicating gonorrhea and Chlamydia infections?

Hello Doctor, I engaged in unprotected oral sex with a stranger on a certain day, and seven days later, I noticed a yellowish-white discharge from the urethral opening and experienced painful erections.
After my first visit to the doctor, I was diagnosed with a urinary tract infection and took doxycycline for three days (two pills a day), but there was no significant improvement.
During my second visit, blood tests showed a Chlamydia antibody titer of 1:16 (+), but I was not informed whether gonorrhea was tested.
I then took doxycycline for another eight days (three pills a day) but still saw no noticeable improvement.

On my third visit to a different urology clinic, the doctor administered an injection and gave me four white pills to take immediately.
The next day, all my symptoms disappeared, and there was no discharge or pain.
My urine test results came back normal.
The doctor stated that no further testing was necessary and that I did not need to continue taking doxycycline, indicating that I had fully recovered.

My question is, do I still need to continue taking doxycycline? Is it possible that Chlamydia could persist after 11 days of antibiotic treatment? I am worried that Chlamydia or gonorrhea could still be present in my body, and I am concerned about the risk of transmitting it to my partner during sexual activity.
Thank you, Doctor, for taking the time to read my lengthy message, and I appreciate your response.

Niming, 30~39 year old female. Ask Date: 2020/07/31

Dr. Du Shixi reply Urology

Hello: The treatment for gonorrhea follows certain guidelines, which can be referenced.
It is recommended to use doxycycline for 14 days; however, in some cases, issues may arise due to antibiotic resistance or non-compliance with the medication regimen, and there is no guarantee of 100% effectiveness.
Routine testing can only provide limited information.
Such diseases can spread rapidly through sexual contact.
The second hospital you mentioned did not provide a specific medication name, which makes the current situation quite awkward.
A normal urinalysis result is a good sign.
Generally, after treatment, if there are no symptoms, a follow-up check-up should be scheduled 2-3 months later.
If symptoms occur, please return for a consultation.
It is advisable to practice safe sex by using condoms.
Wishing you good health.

Reply Date: 2020/07/31

More Info

It sounds like you've been through a challenging experience regarding your health, and it's commendable that you're seeking clarity on your treatment. Let's break down your situation regarding the treatment of gonorrhea and chlamydia, and address your concerns about the medications you've taken.

From your description, it appears that you initially experienced symptoms consistent with a sexually transmitted infection (STI) after engaging in unprotected oral sex. The symptoms you described, such as the yellowish discharge and pain during erection, are indeed indicative of potential infections like chlamydia or gonorrhea.
You were prescribed doxycycline, which is an antibiotic effective against chlamydia. However, it’s important to note that doxycycline is not the first-line treatment for gonorrhea, which is often treated with a combination of antibiotics, typically ceftriaxone and azithromycin. The fact that you did not see improvement after taking doxycycline for an extended period raises concerns about whether the correct treatment was administered for your specific infection.

After your second visit, where you tested positive for chlamydia antibodies, it seems you continued doxycycline for a total of 11 days. While doxycycline can be effective for chlamydia, the persistence of your symptoms suggests that either the infection was not fully treated or that you may have had a concurrent gonorrhea infection that was not addressed.
When you visited the third urologist, it sounds like you received a different treatment approach, which led to an immediate resolution of your symptoms. This is promising, as it indicates that the treatment you received was effective. The injection and the four pills you took likely contained antibiotics that are effective against both chlamydia and gonorrhea.

Regarding your question about whether you should continue taking doxycycline: since your symptoms have resolved and your urine test results returned to normal, it is generally not necessary to continue taking doxycycline. Continuing an antibiotic without symptoms or a clear indication of an ongoing infection can lead to antibiotic resistance and other complications.

As for your concerns about the possibility of residual chlamydia or gonorrhea, it’s understandable to be worried about transmitting an infection to a partner. If you have completed the treatment prescribed by the third doctor and your symptoms have resolved, it is likely that you are no longer infectious. However, it is always a good practice to inform any sexual partners about your previous infection and to encourage them to get tested, especially if they have any symptoms.

In conclusion, based on your current situation, you should not continue taking doxycycline, especially since your symptoms have resolved and your urine test was normal. However, if you have any lingering concerns or if you experience any new symptoms, it would be wise to follow up with your healthcare provider for further evaluation. Regular STI screenings and open communication with partners are key to maintaining sexual health.
If you have any further questions or need additional clarification, don’t hesitate to reach out to your healthcare provider. They can provide personalized advice based on your medical history and current health status. Stay safe and take care!

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