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Effective antibiotic for GONORRHEA besides AZITHROMYCIN.

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I have read that certain antibiotics are more effect towards gonorrhea.

I took 1g of Azithromycin and 200mg of Cefpodoxime proxetil.. one dose / both tablet

I took these within 13 hours, after receiving unprotected fellatio, from a possible high risk woman in South Korea. I have also read that this regimen is only 75% effect against pharyngeal infection.

"Cefpodoxime proxetil 200 mg is less active against N. gonorrhoeae in vitro than cefixime and also does not quite meet the minimum efficacy criteria with cure rates, 96.5% (95%CI 94.8-98.9%) for urogenital and rectal infection; efficacy in treating pharyngeal infection is also unsatisfactory, 78.9% (95%CI 54.5-94%)"

I have two main questions.

1. Although this regimen is less effective against possible N. Gonorrhoeae, would it be more effective because of how early i took it after possible infection. Because there was very little time for the bacteria to multiply and cause a bigger infection. ????

2. i know a pharyngeal infection is in the throat, so i am wondering does this bacteria get stronger while there, hence if i get a urogenital infection (from fellatio) its essentially the same kind of infection just in a different location. Meaning should i consider my regimen taken for a possible urogenital infection, with the same percentage of success, as that of a pharyngeal infection? Or is it a totally different situation depending on the location of infection?

3. It's been seven days since taking the Antibiotic Regimen. Would it be safe to trust a Test Cure at this point, or at 14 days, with the thinking that the there is a possible risk of; of a semi infective antibiotic treatment that could have killed enough bacteria to result in a false negative? Is a PCR test sensitive enough to prevent a false negative?

I have done a lot of research on this and I hope you can help me.



Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 28 Doctors Online

Thank you for your query at
I understand your concern.
To answer your queries:
1) The effectiveness of an antibiotic definitely depends on how early you start the antibiotic, also it shows a cure rate of almost 95 %, which is extremely high, and I will say is a good choice antibiotic. No matter what studies say, even with other drugs such as Cefixime, people have come back with resistance.
2) Pharyngeal infection of the throat is caused by a different pathogen, and it is difficult to predict whether Cefpodoxime will work. You can wait for a couple of days and if you do not see improvement, please start Amoxicillin after talking to your physician which is good against throat infections.
3) Yes you check for the status of the infection, if it has been cured, the test will be negative, and there is no chance of false negative.

Patient replied :

3. I have had no symptoms at all, and like I said I took the antibiotics after only 13 hours of possible infection, so I may not even have the infection. Is 15 days after possible infection (14 days after taking precautionary antibiotics), a long enough time for any possible resistant bateria to show up on a (NAATs / PCR) test?
This is why I worry about a possible false negative, because that may not be enough time for possible resistant bacteria to multiply to a detectable point. ???????
2. I have no symptoms in my throat, because it never came into contact with any bacteria during the sexual act, only my penis.
1. Is the effectivness of the antiobiotics based on the actually pathogen or on the mucus membrain in which the infection is being held? Anatomic Site of Infection
4. Would resistant N. Gonorrhea be so resistant that the antibiotics would have no effect on them what so ever?
PS: I haven't had any symptoms at all and it has been 8 days after possible infection. 7 days after taking PRECAUTIONARY antibiotics. The regimen mentioned in my first submission.

The incidence of gonorrhoea being resistant is low, and when you initiate treatment at the right time, then it is not possible to develop resistance. Most resistant organisms develop because of delay in initiating antibiotics and that's what leads to the resistance.
Moreover, resistance also develops due to incomplete antibiotic course. You finished your course.
The effectiveness of antibiotics depends on the site as well as the immunity of the individual. If you're immunocompromised then the chances of developing resistance is higher.
N. Gonorrohoea does not really cause resistance once you initiate antibiotic at the right time. So you should not worry.
Hope this was helpful,

Patient replied :

Thanks doctor.
1. What are chances of catching HIV from this unprotected blowjob?
2. Should I worry about getting tested?
3. Do you think it is safe to have unprotected sex with a monogamous partner?



The chance of getting HIV from unprotected blowjob is almost negligible. There has never been any reported case of HIV from unprotected blowjob till date.
- You do not need any testing.
- Yes, provided you both are free of STDs from previous exposures.
Hope this was helpful,

Patient replied :

What specific STD's should i test for after this encounter. I have a partner that i have unprotected sex with and i wanna make sure i am clear before having unprotected sex with her again.


Thanks for the follow up.
You should get Herpes and Gonorrhea tests done.
Since you completed the antibiotic regimen the chances of acquiring gonorrhea are minimal. However, you can go ahead and get yourself tested.

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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