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I had a young female pt that came back positive with GC and Chlamydia. On the CDC website the recommendation says that pt is treated with ceftriaxone 250 mg IM and addition of azythro 1g once or doxy 100 mg bid ... what if ceftriaxone is not available?? guideline says cefixime no longer recommended... but can be used as an alternative ..

 

how do you take care of those pts folks? if ceftriaxone not available?

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You can treat CT/NG with 2g of azithro stat to cover for both but efficacy might be so-so

 

Test of cure for sure p 7 days.

 

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also 2 gm of zithromax makes almost everyone throw up...

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asked this question to the local STD clinic (state funded)

they said Rocephin is really the only treatment that works - if the drug stores our out we can now call them directly and they have a stock pile of the drug - they will dispense/treat patient

 

It is a state funded clinic so they can do this

 

 

 

as a side not - GC is one of the REALLY MEAN NASTY bugs that is becoming resistant to just about everything - I would do a test for cure on anyone that you did not do the rocephin IM in your office to ensure they got treated

 

also, reportable in my state as it has the potential to be a huge public health nightmare is MultiDrugResistance MRD - grows......

 

another reason counsel safe sex

Thank you so much everyone for your input. and yes Ventana that's exactly what my SP said when i reported .. good luck tx'ing the pt because GC is a nightmare and the problem is yes you need to tx partner (and i told pt about that over the phone but not sure she will show up with him to be tx'ed) ... I gave my patient a place to go (free std clinic close to her) in case they (she and her partner) don't show up at my clinic which is a research clinical trial.

also 2 gm of zithromax makes almost everyone throw up...

 

True but they should have wrapped it up...I only write this for cephalosporin allergic pts, BTW, but op asked for alternatives to ceftriaxone/azithro...

 

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