Azithromycin's potential in treating Sexually Transmitted Infections explored.
In the realm of sexual health, it is crucial for sexually active males who have sex with males to take regular tests for common sexually transmitted infections (STIs). Here are some key points to consider:
Testing Recommendations
- It is advisable for adults and adolescents aged 13-64 to test at least once for HIV.
- For the dual treatment of gonorrhea, a combination of a single dose of 2 grams of azithromycin orally and a single intramuscular injection of 240 milligrams of gentamicin is often prescribed.
- It is recommended that sexually active males test at least once a year for syphilis, chlamydia, gonorrhea, and HIV. If living with HIV, testing for hepatitis C is also crucial.
- A person who has had oral or anal sex may want to consult a healthcare professional about throat and rectal testing options.
Treatment Options
Azithromycin
Azithromycin is an antibiotic that can treat chlamydia, nongonococcal urethritis, and cervicitis. It is available in both tablet and powder formulations.
- For treating chlamydia, a single dose of 1 gram of azithromycin orally is typically prescribed.
- Azithromycin may also be used in dual therapy with gentamicin to treat gonorrhea in certain cases.
However, azithromycin is less effective than doxycycline for treating certain STIs, particularly rectal chlamydia. Doxycycline shows a significantly higher cure rate in such cases.
Doxycycline
Doxycycline is generally preferred for its higher efficacy, especially with a 7-day course, for urogenital chlamydia infections. In non-pregnant patients, doxycycline's longer course and higher efficacy at rectal sites make it the first-line treatment.
Other Antibiotics
Levofloxacin is used in some cases for chlamydia, at 500 mg daily for 7 days. For gonorrhea, which often coexists with chlamydia, treatment usually involves dual antibiotic therapy, not azithromycin or doxycycline alone but typically ceftriaxone with azithromycin or doxycycline as adjuncts.
Contextual Considerations
- Azithromycin is preferred in pregnant patients due to safety and single-dose convenience.
- Both drugs require partners to be treated and sexual abstinence until treatment completion to avoid reinfection.
Side Effects and Precautions
- Side effects of azithromycin may include diarrhea, nausea, vomiting, stomach pain, and headache. More serious side effects can occur in rare cases.
- A pregnant individual may want to consider testing for syphilis, HIV, hepatitis B, hepatitis C, chlamydia, and gonorrhea starting in early pregnancy.
- Transgender and gender diverse persons should follow screening recommendations based on their anatomy and may want to consider annual testing, depending on their risk factors.
- A fast, pounding, or irregular heartbeat can be a side effect of azithromycin.
- Dizziness and fainting are potential side effects of azithromycin.
Prevention
Pre-exposure vaccination, condoms, and abstinence or reduction in number of sexual partners can help prevent or decrease the risk of contracting an STI.
Untreated STIs can lead to further health complications, such as infertility, long-term abdominal pain, testicular pain and infertility, problems during pregnancy, and it is possible for a pregnant person's baby to contract the infections during delivery.
It is essential to remember that sexual health is an ongoing concern and regular testing and safe practices are crucial for maintaining good health. Always consult with a healthcare professional for personalised advice and guidance.
[1] Centers for Disease Control and Prevention. (2021). Sexually Transmitted Diseases Treatment Guidelines, 2021. https://www.cdc.gov/std/tg2021/default.htm
[2] World Health Organization. (2016). Guideline: Sexually transmitted infection (STI) management for adults and adolescents. https://www.who.int/publications/i/item/9789241549603
[3] British Association for Sexual Health and HIV. (2019). BASHH Guidelines for the Management of Chlamydia Trachomatis and Neisseria Gonorrhoeae Infections in Sexually Active Men Who Have Sex with Men. https://www.bashh.org/media/1002/bashh-guidelines-chlamydia-trachomatis-and-neisseria-gonorrhoeae-infections-in-sexually-active-men-who-have-sex-with-men.pdf
[4] British Association for Sexual Health and HIV. (2016). BASHH Guidelines for the Management of Azithromycin Resistant Neisseria Gonorrhoeae. https://www.bashh.org/media/994/bashh-guidelines-azithromycin-resistant-neisseria-gonorrhoeae.pdf
[5] British Association for Sexual Health and HIV. (2016). BASHH Guidelines for the Management of Chlamydia Trachomatis. https://www.bashh.org/media/993/bashh-guidelines-chlamydia-trachomatis.pdf
- In addition to regular STIs testing, it's prudent for individuals to consider screening for chronic diseases such as hepatitis C, particularly if they are living with HIV.
- Since Azithromycin is less effective against rectal chlamydia compared to Doxycycline, healthcare professionals may advise different treatment options based on the specific location of infection.
- Beyond sexual health, mental health is equally important, so it's advisable for individuals to explore stress management techniques, such as the use of CBD, as part of their overall health and wellness routine.
- leveraging various resources like the Centers for Disease Control and Prevention, World Health Organization, and the British Association for Sexual Health and HIV can provide further guidance on testing, treatment options, and prevention strategies for common STIs like gonorrhea and chlamydia.
- Regular screenings can help detect mental health conditions early, fostering timely interventions and supporting efficient management of these health concerns, emphasizing the interdependence of mental and sexual health.
