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The FP told the patient that it was likely that he had nongonococcal urethritis caused by chlamydia. The urine test was sent for nucleic acid amplification testing to detect chlamydia and gonorrhea. (Note: The discharge is clearer and less purulent with chlamydia than it is with gonorrhea.)
The FP prescribed azithromycin 1 g orally for presumed chlamydia. As an alternative, the FP could have prescribed doxycycline 100 mg orally twice a day for 7 days. Other less commonly used alternate regimens include:
- erythromycin base 500 mg 4 times a day for 7 days
- erythromycin ethylsuccinate 800 mg 4 times a day for 7 days
- ofloxacin 300 mg orally twice a day for 7 days
- levofloxacin 500 mg orally once daily for 7 days.
The patient was also given a prescription for 1 g azithromycin to give to his girlfriend if the urine testing came back positive. When it did come back positive, the FP called the patient and asked him to discuss the situation with his girlfriend and to offer her the prescription.
The patient was counseled to make sure his girlfriend wasn’t allergic to azithromycin and to give her the option of going to her own physician, rather than just taking the prescription as is. This process is called expedited partner therapy. Legal status by state is available at http://www.cdc.gov/std/ept/legal/default.htm. Currently EPT is prohibited in 7 states.
Text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. Photograph courtesy of University of Washington STD/HIV Prevention Training Center. This case was adapted from: Chumley H. Gonococcal urethritis. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill; 2009:921-923.
To learn more about The Color Atlas of Family Medicine, see:
• http://www.amazon.com/Color-Atlas-Family-Medicine/dp/0071474641
You can now get The Color Atlas of Family Medicine as an app for mobile devices including the iPhone and iPad by clicking this link:
The FP told the patient that it was likely that he had nongonococcal urethritis caused by chlamydia. The urine test was sent for nucleic acid amplification testing to detect chlamydia and gonorrhea. (Note: The discharge is clearer and less purulent with chlamydia than it is with gonorrhea.)
The FP prescribed azithromycin 1 g orally for presumed chlamydia. As an alternative, the FP could have prescribed doxycycline 100 mg orally twice a day for 7 days. Other less commonly used alternate regimens include:
- erythromycin base 500 mg 4 times a day for 7 days
- erythromycin ethylsuccinate 800 mg 4 times a day for 7 days
- ofloxacin 300 mg orally twice a day for 7 days
- levofloxacin 500 mg orally once daily for 7 days.
The patient was also given a prescription for 1 g azithromycin to give to his girlfriend if the urine testing came back positive. When it did come back positive, the FP called the patient and asked him to discuss the situation with his girlfriend and to offer her the prescription.
The patient was counseled to make sure his girlfriend wasn’t allergic to azithromycin and to give her the option of going to her own physician, rather than just taking the prescription as is. This process is called expedited partner therapy. Legal status by state is available at http://www.cdc.gov/std/ept/legal/default.htm. Currently EPT is prohibited in 7 states.
Text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. Photograph courtesy of University of Washington STD/HIV Prevention Training Center. This case was adapted from: Chumley H. Gonococcal urethritis. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill; 2009:921-923.
To learn more about The Color Atlas of Family Medicine, see:
• http://www.amazon.com/Color-Atlas-Family-Medicine/dp/0071474641
You can now get The Color Atlas of Family Medicine as an app for mobile devices including the iPhone and iPad by clicking this link:
The FP told the patient that it was likely that he had nongonococcal urethritis caused by chlamydia. The urine test was sent for nucleic acid amplification testing to detect chlamydia and gonorrhea. (Note: The discharge is clearer and less purulent with chlamydia than it is with gonorrhea.)
The FP prescribed azithromycin 1 g orally for presumed chlamydia. As an alternative, the FP could have prescribed doxycycline 100 mg orally twice a day for 7 days. Other less commonly used alternate regimens include:
- erythromycin base 500 mg 4 times a day for 7 days
- erythromycin ethylsuccinate 800 mg 4 times a day for 7 days
- ofloxacin 300 mg orally twice a day for 7 days
- levofloxacin 500 mg orally once daily for 7 days.
The patient was also given a prescription for 1 g azithromycin to give to his girlfriend if the urine testing came back positive. When it did come back positive, the FP called the patient and asked him to discuss the situation with his girlfriend and to offer her the prescription.
The patient was counseled to make sure his girlfriend wasn’t allergic to azithromycin and to give her the option of going to her own physician, rather than just taking the prescription as is. This process is called expedited partner therapy. Legal status by state is available at http://www.cdc.gov/std/ept/legal/default.htm. Currently EPT is prohibited in 7 states.
Text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. Photograph courtesy of University of Washington STD/HIV Prevention Training Center. This case was adapted from: Chumley H. Gonococcal urethritis. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill; 2009:921-923.
To learn more about The Color Atlas of Family Medicine, see:
• http://www.amazon.com/Color-Atlas-Family-Medicine/dp/0071474641
You can now get The Color Atlas of Family Medicine as an app for mobile devices including the iPhone and iPad by clicking this link: