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Chlamydia/Gonorrhea Treatment

This treatment plan reviews the risks and benefits of the treatment we are recommending. Please make sure to read it and the manufacturer's pamphlet that comes with the medicine. The manufacturer's pamphlet contains the full information on interactions, side effects, and other important information you should know about the medicine before you start.

Instructions

You have stated that you wish to take medication for your symptoms of gonorrhea and/or chlamydia. Azithromycin 500mg two tablets taken orally once, in combination with cefixime 800mg as a single oral dose will control the infection with these bacteria, which commonly transmits during sexual activity with an infected partner. Signs of this infection include pain, foul-smelling discharge with or without itching or burning with urination. Chlamydia and/or gonorrhea can cause pain or discomfort during intercourse and can be transmitted between male/female sexual partners or female/female sexual partners.

Empiric therapy for an exposed partner to a chlamydial infection should be offered. Patients with a recent known or possible sexual exposure to chlamydia should also be offered empiric therapy. If you are sexually active please disclose to your partner that they may need to seek treatment otherwise with continued sexual interaction re-infection may occur in either partner.

Active Ingredients

This medicine contains the following active ingredients. If you are allergic to any of these components, similar components, or any of the others components listed in the manufacturer's pamphlet do not take it and call or message us immediately.

• Azithromycin
• Cefixime
  
  

Allergies

This medicine may cause an allergic reaction if you are allergic to similar medicines or components. If you are allergic to any of the following please stop the medicine and call or message us or see your doctor in-person:

Cefixime:

• Penicillins: Amoxicillin, penicillin V.,penicillin G (Pfizerpen, Permapen), amoxicillin (Amoxil), amoxicillin/clavulanate (Augmentin), ampicillin (Unasyn), nafcillin (Nallpen), oxacillin (Bactocill), dicloxacillin.
• Other cephalosporins: Cephalexin, Cefotetan, cefuroxime, cefoxitin, Ceftriaxzone, ceftazidime, cefixime, cefdinir

Azithromycin:

• erythromycin
• other macrolide (eg, azalide or ketolide) antibiotics
• pimozide
  
  

Conditions

We have evaluated your health history and the specific health information you provided us, however if anything changes and you develop or discover that one of these conditions applies to you please stop taking this medicine and call or message us immediately:

Cefixime:

• Pregnancy
• Liver problems
• Blood disorders
• Kidney Failure
  
  

Azithromycin:

• Pregnancy
• Central nervous system problems
• Liver problems
• Blood disorders
• Prolonged QTc syndrome
  
  

Pregnancy and Breastfeeding

Oral Azithromycin crosses the fetal placental barrier in pregnancy. It is also present in breastmilk after oral intake. Current studies suggest that this medication is safe both in pregnancy and breastfeeding; however, infants should be monitored for GI disturbances, somnolence, rash, decreased appetite, or diarrhea.

Cefixime does cross the placental barrier in pregnancy however no observed effects have been reported. It is unknown if Cefixime is present in breast milk.

Emergency Side Effects

This medicine can cause dangerous and potentially life threatening side effects. If any of the emergency side effects listed in the manufacturer's pamphlet or those below happen to you please stop taking the medicine and call 911 or seek immediate medical help in-person:

• Hearing changes (such as decreased hearing, deafness)
• Eye problems (such as drooping eyelids, blurred vision)
• Difficulty speaking/swallowing
• Muscle weakness
• Signs of liver problems (such as unusual tiredness, persistent nausea/vomiting, severe stomach/abdominal pain, yellowing eyes/skin, dark urine)
• Fast/irregular heartbeat
• Severe dizziness
• Fainting
  
  

Other Side Effects

This medicine can also cause other side effects. If any of the other side effects listed in the manufacturer's pamphlet or those below happen to you please stop taking the medicine and call or message us or see your doctor in-person:

• Upset stomach
• Diarrhea/loose stools
• Nausea
• Vomiting
• Abdominal pain
  
  

Medicines, Supplements, and Foods

We have evaluated your health history and the specific health information you provided us, however if anything changes and you start or discover that you are taking any of the medicines, foods, or supplements listed below call or message us before you take the medicine. Some of these can cause dangerous interactions with the medicine we are prescribing you and we will help you evaluate that risk and decide on an appropriate treatment plan:

• HIV medications
• Birth control (all hormonal)
• Narcotic pain medications
• Anti-seizure medications
• Antipsychotic medications
  
  

Accurate Information

We have evaluated the specific health information you provided and are making our recommendations based on it. If you forgot to provide or incorrectly provided that information we may misdiagnose or fail to diagnose conditions that you may have which could affect our recommendation for treatment. If you need to clarify or update any information about your health you can message or call us anytime.

Treatment Failure

This treatment is not 100% effective. It may not work or may only partially resolve the condition for which you are seeking treatment. If the treatment is not working, or if you are experiencing new or worsening symptoms, give us a call or message us anytime. If it is an emergency call 911 or seek immediate medical help in-person. You may need to seek alternative treatment such as those listed below or in the follow-up plan.

Misdiagnosis or Delayed Diagnosis

There is also a risk that we will misdiagnose or fail to diagnose conditions that you may have which could affect our recommendation for treatment. This risk exists with a doctor in-person as well but they may have additional signs and symptoms to aid their evaluation. We use the evidence based practice and guidelines as well as clinical decision support to try to minimize these risks.

Accepting or Declining Our Recommendation

We are recommending this treatment for you because the potential benefits of treatment outweigh the risks.. You should evaluate this information as well as the manufacturer's pamphlet, and any input from your in-person healthcare team, or other relevant information to decide if this treatment plan is appropriate for you. You are free to decline our treatment recommendations although, doing so may prolong symptoms and can be associated with other risks or negative outcomes.

Alternative Treatment

We have based our recommendation on your specific case and medical guidelines, but there may be alternative treatments or strategies that may be helpful to you. Some may be more or less effective than what we provide. Some treatments may require an in-person exam or procedure which we can't provide. Message us or talk to your doctor in-person to discuss alternative treatments. Here are some other treatments or strategies that you might consider:

• In-person Pelvic exam with testing
  
  

Share with Your In-Person Healthcare Team

You can access your records anytime. We strongly recommend that you update your in-person doctor, pharmacist, and the rest of your healthcare team to let them know about any new medicines you are taking or other changes in your health.

You can also ask us questions anytime and we are happy to help you share any information about your health with your in-person healthcare team.

Reportable Diagnosis

Chlamydia and Gonorrhea must be reported to the local health authorities. Please expect to receive a call where you will be asked to share your history of recent sexual partners. The local health authorities will notify your partners so that they can be tested and treated.