Azithromycin for STDs: Indications and Limitations
Azithromycin is a macrolide antibiotic used for specific sexually transmitted infections:
- Chlamydia trachomatis: 1 g PO single dose (preferred) or doxycycline 100 mg BID × 7 days.
- Gonorrhea (uncomplicated): Not monotherapy. CDC: Ceftriaxone 500 mg IM + azithromycin 1 g PO (dual therapy) due to rising resistance.
- Mycoplasma genitalium: Azithromycin 500 mg day 1, then 250 mg daily × 4 days (if macrolide-sensitive; resistance testing preferred).
- Syphilis: Not recommended (penicillin is standard); azithromycin only if allergic and desensitization not feasible—resistance documented.
Key Points
- Azithromycin does not treat herpes, HPV, HIV, trichomoniasis, or hepatitis.
- Single-dose convenience improves adherence for chlamydia.
- Always test for co-infections (HIV, syphilis, gonorrhea).
- Partner treatment essential (expedited partner therapy where legal).
Self-medication risks incomplete treatment, resistance, and missed co-infections. See a clinician for proper testing and regimen.
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