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Rocephin 250 MG IM/Zithromax 1 Gram Orally


ZCochrane
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Well as far as I know at this time only oral. And I'm only questionably symptomatic. I get a lot of post nasal drip this time of year. And what occasional symptom I have could be from that.

 

I have to say it's thrown me for a bit of a loop. After I got the text this morning, I was a bit nervous. I think I'm ok now. But this has popped my cherry-ie, it's my first time.

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Why is he Clap....ping?! o_O

I guess he gave Z Cochrane the clap. Don't forget to treat your partners at the same time. Chlamydia can't live in the throat, so the azithromycin was a bit superfluous.

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I guess he gave Z Cochrane the clap. ...Chlamydia can't live in the throat, so the azithromycin was a bit superfluous.

 

I'm not sure that's true. Infants can have nasopharyngeal carriage after passing through an infected birth canal-and as the song says-the mouth is connected to the oral cavity...the oral cavity is connected to the oropharynx .... the oropharynx is connected to the nasopharynx-I hear the word of the Lord!!!

 

Ceftriaxone and Zithromax are what the CDC recommends. (If you'd like the reference, I can give it to you. I perused it thoroughly before going to the Health Department today). And besides treating possible chlamydia, the CDC Guidelines advise to give the Zithromax because of the increasing incidence of resistance in gonorrheal infections. Aside from them proposing that two drugs with different mechanisms of action will treat the gonorrhea better, they are hoping it will cut down on the emergence of further resistance.

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Don't forget to treat your partners at the same time.

 

This is where the problem comes in. Going back 60 days per the CDC Guidelines, I have Partners A, B, C, and D to worry about. They will all be told.

 

To break it down:

 

Partner A and I are most likely not going to see each other again. We only met once. He was a nice guy. But it was most likely a one time thing. I meant to talk to him this evening. But the time got away.

 

Partner B I really like. But I don't think I'm going to see him again either. He unfortunately for me is a heavy smoker. The kind where he has to smoke right before and then again right after as soon as we are finished. His clothes and car reek of smoke. After each time we've met, I start coughing (a bit of asthma), and I smell smoky. I don't think I can take the smoke anymore. I left a voicemail for him to call me this evening, but I haven't heard back yet.

 

The next two are troublesome.

 

Partner C I like, but he only sees me as a fling. In fact he has a boyfriend-and I wouldn't be surprised if they didn't actually have an open relationship. He didn't tell me anything about having a boyfriend the first time we met.

 

Partner D I like too, but I think he has dropped me. The last time we spoke he emphasized we were never going to be boyfriends.

 

I don't know whether to tell C and D myself or give their names to the Health Department. It's possible that the infection came from one of them -or possibly it's from a partner E whom I've already spoken to.

 

I get the feeling that even if I told the Health Department C and D would figure out it was me. For example even though D hasn't wanted to see me lately, when we communicated a few weeks ago, he's said I was the last guy he was with.

 

I guess I should just be prepared for C and D to quit seeing me. But then if they are going to drop me anyway-I could save myself the stress by having the Health Department call them. I'd appreciate it if someone told me. But I'm a stand-up guy. I don't think C and D are particularly stand-up guys the way things have worked out.

 

And C especially worries me- not about him not wanting to see me again. That's upsetting, yes. But I'm more worried if he really doesn't have an open relationship, and if his boyfriend doesn't know he sees other guys-aye, yi, yi. It's like the plot of a movie.

 

I keep going round and round-do I tell them or have the Health Department tell C and D? I don't know aside from my stress whether they would want the Health Department to have their names or would they rather hear it from me.

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My take is that you should tell C and D; in the case of C - I think there is a greater possiblity

of discovery by C's boyfriend if Public Health contacts him.

 

In the case of D the consequences of public health informing him aren't as severe, but

my guess is that most people would prefer getting the news personally.

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I'm not sure that's true. Infants can have nasopharyngeal carriage after passing through an infected birth canal-and as the song says-the mouth is connected to the oral cavity...the oral cavity is connected to the oropharynx .... the oropharynx is connected to the nasopharynx-I hear the word of the Lord!!!

 

Ceftriaxone and Zithromax are what the CDC recommends. (If you'd like the reference, I can give it to you. I perused it thoroughly before going to the Health Department today). And besides treating possible chlamydia, the CDC Guidelines advise to give the Zithromax because of the increasing incidence of resistance in gonorrheal infections. Aside from them proposing that two drugs with different mechanisms of action will treat the gonorrhea better, they are hoping it will cut down on the emergence of further resistance.

 

I checked the CDC's site, and, you're right, as of the 2015 recommendations, they now recommend both when GC is detected in the throat. However, the rationale they give on that website indicates that the reason is the 10% resistance of GC to Rocephin/ceftriaxone, rather than due to the potential transmissibility of chlamydia via sexual encounters.

http://www.cdc.gov/std/tg2015/gonorrhea.htm

Uncomplicated Gonococcal Infections of the Pharynx

Most gonococcal infections of the pharynx are asymptomatic and can be relatively common in some populations (505,506,575,576). Gonococcal infections of the pharynx are more difficult to eradicate than are infections at urogenital and anorectal sites (551). Few antimicrobial regimens, including those involving oral cephalosporins, can reliably cure >90% of gonococcal pharyngeal infections (566,567). Providers should ask their patients with urogenital or rectal GC about oral sexual exposure; if reported, patients should be treated with a regimen with acceptable efficacy against pharyngeal gonorrhea infection.

 

Recommended Regimen



    • Ceftriaxone 250 mg IM in a single dose
      PLUS

  • Azithromycin 1 g orally in a single dose

Other Management Considerations

To maximize adherence with recommended therapies and reduce complications and transmission, medication for gonococcal infection should be provided on site and directly observed. If medications are not available when treatment is indicated, linkage to an STD treatment facility should be provided for same-day treatment. To minimize disease transmission, persons treated for gonorrhea should be instructed to abstain from sexual activity for 7 days after treatment and until all sex partners are adequately treated (7 days after receiving treatment and resolution of symptoms, if present). All persons who receive a diagnosis of gonorrhea should be tested for other STDs, including chlamydia, syphilis, and HIV.

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This is where the problem comes in. Going back 60 days per the CDC Guidelines, I have Partners A, B, C, and D to worry about. They will all be told.

 

To break it down:

 

Partner A and I are most likely not going to see each other again. We only met once. He was a nice guy. But it was most likely a one time thing. I meant to talk to him this evening. But the time got away.

 

Partner B I really like. But I don't think I'm going to see him again either. He unfortunately for me is a heavy smoker. The kind where he has to smoke right before and then again right after as soon as we are finished. His clothes and car reek of smoke. After each time we've met, I start coughing (a bit of asthma), and I smell smoky. I don't think I can take the smoke anymore. I left a voicemail for him to call me this evening, but I haven't heard back yet.

Tell them all. You'll get that much more respect. It doesn't sound like you're in a monogamous relationship yourself, so no one should be upset with you. If they're not grateful you told them, they're idiots. I feel a song coming on....

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Tell them all. You'll get that much more respect. It doesn't sound like you're in a monogamous relationship yourself, so no one should be upset with you. If they're not grateful you told them, they're idiots. I feel a song coming on....

 

About that video-is the song actually from the Mikado? I don't remember it.

 

It's interesting-I'm assuming this company may be mainly composed of Belgiums-although I guess it's possible the company is international-but I understand them a lot better than I have some American or English productions of G&S. I have some hearing loss -but even before that-it can be difficult to understand G&S lyrics due to poor diction, music too loud, bad acoustics. I find this to be true even on recorded G&S.

 

Gman

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About that video-is the song actually from the Mikado? I don't remember it.

 

It's interesting-I'm assuming this company may be mainly composed of Belgiums-although I guess it's possible the company is international-but I understand them a lot better than I have some American or English productions of G&S. I have some hearing loss -but even before that-it can be difficult to understand G&S lyrics due to poor diction, music too loud, bad acoustics. I find this to be true even on recorded G&S.

 

It's Belgians, not Belgiums! :mad:;)

 

And, yes, it's from the Mikado. Not one of the more celebrated arias--it's near the middle of the 2nd act if I can recall. Our local G&S company, the Lamplighters, always has supertitles like at the opera so one can understand what they're singing. Most of the time, it would be difficult otherwise. Especially those rapid unintelligible patters, which are rarely understood, and if they are it doesn't matter...

 

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Robin

 

My eyes are fully open to my awful situation—

I shall go at once to Roderic and make him an oration.

I shall tell him I've recovered my forgotten moral senses,

And I don't care twopence-halfpenny for any consequences.

Now I do not want to perish by the sword or by the dagger,

But a martyr may indulge a little pardonable swagger,

And a word or two of compliment my vanity would flatter,

But I've got to die tomorrow, so it really doesn't matter!

Des.So it really doesn't matter—

Mar.So it really doesn't matter—

All. So it really doesn't matter, matter, matter, matter, matter!

 

Margaret

 

If I were not a little mad and generally silly

I should give you my advice upon the subject, willy nilly;

I should show you in a moment how to grapple with the question,

And you'd really be astonished at the force of my suggestion.

On the subject I shall write you a most valuable letter,

Full of excellent suggestions when I feel a little better,

But at present I'm afraid I am as mad as any hatter,

So I'll keep 'em to myself, for my opinion doesn't matter!

Des.Her opinion doesn't matter—

Rob.Her opinion doesn't matter—

All. Her opinion doesn't matter, matter, matter, matter, matter!

 

Despard

 

If I had been so lucky as to have a steady brother

Who could talk to me as we are talking now to one another—

Who could give me good advice when he discovered I was erring

(Which is just the very favour which on you I am conferring),

My story would have made a rather interesting idyll,

And I might have lived and died a very decent indiwiddle.

This particularly rapid, unintelligible patter

Isn't generally heard, and if it is it doesn't matter!

Rob.If it is it doesn't matter—

Mar.If it ain't it doesn't matter—

All. If it is it doesn't matter, matter, matter, matter, matter!

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Update: So far I've taken the easy way out. I told A and B.

 

A-most likely wasn't going to see again. He's an older dude than I am by about 7 years. He actually told me he is planning on giving up the gay life. He was married until about 5 years ago ( has an adult child not very copacetic with him being gay), but he had had man to man experience before his marriage. He thinks we (not me-gay men in general) aren't stable and are too promiscuous. I told him the hook-up apps might not be the best place to find someone monogamous (although there are guys on there who do say they are looking for monagamy, so I might be wrong.) He thanked me for telling him.

 

B-seemed to be ok and at least said he wants to meet me after my treatment is finished. I like him, and would like that except for the smoking. He said he didn't blame me. I think he's had similar experiences before.

 

The one thing that bothers me about both A & B is I don't know how seriously they are taking the need to get checked. B at least said it was about time for his yearly check up. But it could take weeks for him to get in. Neither one wanted me to give their name to the Health Department. And even though I explained it, I don't know if they understand the need for urine tests. The local gay center where a lot of us go for anonymous testing is outside the Health Department. They perform most testing. But they don't do the urine. They say they don't have the funds, and with genital infections men should be symptomatic. And while that's true, it's not always true.

 

As for C & D-not all my labs were back at the Health Department on Tuesday. I'm going to call them, so that I have 100% of the information before I tell them.

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This is where the problem comes in. Going back 60 days per the CDC Guidelines, I have Partners A, B, C, and D to worry about. They will all be told.

 

To break it down:

 

Partner A and I are most likely not going to see each other again. We only met once. He was a nice guy. But it was most likely a one time thing. I meant to talk to him this evening. But the time got away.

 

Partner B I really like. But I don't think I'm going to see him again either. He unfortunately for me is a heavy smoker. The kind where he has to smoke right before and then again right after as soon as we are finished. His clothes and car reek of smoke. After each time we've met, I start coughing (a bit of asthma), and I smell smoky. I don't think I can take the smoke anymore. I left a voicemail for him to call me this evening, but I haven't heard back yet.

 

The next two are troublesome.

 

Partner C I like, but he only sees me as a fling. In fact he has a boyfriend-and I wouldn't be surprised if they didn't actually have an open relationship. He didn't tell me anything about having a boyfriend the first time we met.

 

Partner D I like too, but I think he has dropped me. The last time we spoke he emphasized we were never going to be boyfriends.

 

I don't know whether to tell C and D myself or give their names to the Health Department. It's possible that the infection came from one of them -or possibly it's from a partner E whom I've already spoken to.

 

I get the feeling that even if I told the Health Department C and D would figure out it was me. For example even though D hasn't wanted to see me lately, when we communicated a few weeks ago, he's said I was the last guy he was with.

 

I guess I should just be prepared for C and D to quit seeing me. But then if they are going to drop me anyway-I could save myself the stress by having the Health Department call them. I'd appreciate it if someone told me. But I'm a stand-up guy. I don't think C and D are particularly stand-up guys the way things have worked out.

 

And C especially worries me- not about him not wanting to see me again. That's upsetting, yes. But I'm more worried if he really doesn't have an open relationship, and if his boyfriend doesn't know he sees other guys-aye, yi, yi. It's like the plot of a movie.

 

I keep going round and round-do I tell them or have the Health Department tell C and D? I don't know aside from my stress whether they would want the Health Department to have their names or would they rather hear it from me.

They should hear it from you, not the Health Dept.

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Ok Next Update: I told C and D. I get the feeling this might not be the 1st time they dealt with GC-D especially. They both took it well though.

 

So far no one I called has admitted to being symptomatic.

 

It still is very weird to me that this happened. I don't give a lot of oral. I also don't know where I could have gotten it from. I wonder if it could have been from the last escort I saw which I did not include in my above posts about partners. But I contacted him and told him too.

 

I don't usually meet with that many guys. It must have been a good and unusual two month period (the CDC advises you to go back 60 days). As of the end of August I had gone three months without having sex. I guess when they say feast or famine they are telling the truth.

 

But for this past 60 days including the escort, I've been with 6 -really 7 (#7 shouldn't be at risk if the urine test was accurate). I was with the escort twice, B twice, C three times (but he was only at risk the 1st and last time), Y twice (but he might not be at risk), A once, and # 7 once (who shouldn't be at risk at all if the urine tests were accurate).

 

I hope I haven't missed anyone in that 60 days period. I went back through my texts. And these were the only guys I could find.

 

 

As for me I notice my throat doesn't hurt much in the morning. In the evening it gets a little sore. But I think it's probably more post-nasal drip than due to my infection.

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