Quote: (02-13-2014 01:51 AM)DaveR Wrote:
Such as?
For starters, yes you can breed resistant bacteria within your own body through overexposure. This can happen during the course of treatment for an actual infection or you can do it by selecting for resistance genes in bacteria that are already there (some of them are on DNA plasmids that can be transferred between bacteria). If you take antibiotics without a proven or strongly suspected infection (i.e. you are symptomatic, have a positive test, or have sex with someone with a known infection), you're making it more likely that you'll have a resistant strain the next time you really do get an STD. To give one example, azithromycin can be bad to select resistance for if you get sinus infections--you really don't want Z-packs to not work for those.
Taking antibiotics also wipes out a good amount of your good gut bacteria. Flagyl (metronidazole) in particular kills a lot of anaerobic bacteria that live in your GI tract (cefixime and doxycycline are also broad-spectrum and aren't great for it either). You can then get overgrowth of bacteria that aren't usually present in large numbers, which can lead to GI upset or even some
nasty infectious diarrhea, which is on the rise. There is not good evidence that taking probiotics can prevent this.
Moreover, all of those antibiotics do have side effects. Flagyl and cephalosporins like cefixime cause nausea and diarrhea (and you get really sick if you drink on flagyl). Cephalosporins can also cause a rash, hives or other allergic reaction. Doxycycline makes you very sensitive to sunlight (people on doxy for malaria prophylaxis are recommended to wear sunscreen when they go outside).
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The ones I listed are on the CDC's list for prophylaxis... I've been given a script for all three when I told a doc that I banged a dirty girl by mistake. Doxycycline is regularly prescribed for months at a time as Malaria protection.
Prophylaxis means treating presumptively (with or without symptoms) when you don't have a positive test yet. It's done when you've had sex with someone who has a known STD or when you have STD symptoms, not "Doc I rawdogged 3 really slutty-seeming chicks can I get some pills?". Even then you should still get a test (which can identify other STDs you may have acquired)--it just means you don't delay treatment until you know the results.
You can take doxycycline as malaria prophylaxis because the potential risks of therapy are way better than getting malaria. And the regimens used for malaria prevention aren't the same ones used for treatment so there is less risk of resistance developing as a result of prophylaxis.
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If you're worried about resistance, it's a problem for society and the medical community to deal with, not you individually... there's nothing you can do to avoid some other guy from not taking the full course and potentially creating a resistant strain. Taking a round of antibiotics occasionally is not the issue.
Like I said above this is not true. And moreover, widespread resistance will soon be all of our problem if enough people think like this (to an extent it already is).
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In addition, there are issues with testing for Trich in men, and oral Chlamydia is difficult to test for in general.
Apparently you can test for Chlamydia in places other than your dick:
Quote:CDC guideline on Chlamydial infections Wrote:
Rectal and oropharyngeal C. trachomatis infection in persons engaging in receptive anal or oral intercourse can be diagnosed by testing at the anatomic site of exposure. Most tests, including NAAT and nucleic acid hybridization tests, are not FDA-cleared for use with rectal or oropharyngeal swab specimens, and chlamydia culture is not widely available for this purpose. However, NAATs have demonstrated improved sensitivity and specificity compared with culture for the detection of C. trachomatis at rectal sites (278–280) and at oropharyngeal sites among men (278–281). Some laboratories have met CLIA requirements and have validated NAAT testing on rectal swab specimens for C. trachomatis.
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Source)
Testing for trichomoniasis in men is by culture from urine or urethral swab, or NAAT (I've never seen the semen test lol):
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In men, wet preparation is not a sensitive test, and no approved point-of-care tests are available. Culture testing of urethral swab, urine, or semen is one diagnostic option; however, NAATs (i.e., PCR or transcription-mediated amplification [TMA]) have superior sensitivity for T. vaginalis diagnosis in men (356,359).
This is the full CDC treatment guideline for STDs:
http://www.cdc.gov/std/treatment/2010/ST...RR5912.pdf
tl;dr: yes you can treat known or strongly suspected STDs before knowing the results of testing. But you should get tested anyway and you should not take antibiotics "just in case" every X number of notches or rawdogs.