Cefspan - Cefixime Antibiotic Pills - Quick Question

[mattk1]

Hi guys,

I wonder if anyone can help me out here as the pharmacist's English wasn't great and my Thai is even worse

I know from research on the internet that I need 400mg Cefixime antibiotics to clear up the mess I got myself into. I found the brand name available here in Thailand is Cefspan which came in 100mg tablets (10 in a pack).

My question is can I just take 4 of these pills in one go equaling the 400mg (thus 'one shot') or is that not how it works? I ask as the pharmacist told me to take one every 12 hours.

If anyone can help me out I would be very grateful!

[Sheryl]

4 tabs will indeed be 400mg.

However if this is gonorrhea you are treating, cefixime is no longer recommended due to widespread drug resistance.

http://contemporaryobgyn.modernmedicine.com/news/cefixime-no-longer-recommended-treatment-gonorrhea

Also need to be aware that drug resistance in Thailand is much worse than in the West, so if it is Thai-acquired GC even the current CDC recs may not apply.

the best thing to do is to go to the Thai Red Cross Anonymous Clinic. They see more of this than anyone and are completely up to date on trends in drug resistance

hai Red Cross · Anonymous Clinic

104 Ratchadamri Road

Pathumwan, Bangkok 10330.

Tel. 02-252-2568-9

It is located between the Sala Daeng and Radchadamri Road

(Apologies if this is not for GC -- but I can't think what else one would take a 400 mg single does for)

[jrtmedic]

+ if Sheryl is correct in her assumption (and I would share her opinion) then self diagnosis/treatment is hazardous.

The poster has no way of knowing for sure exactly what he is suffering from. If he has exposed himself to risk and is now suffering symptoms it is very important that he seek expert help.

A full STD screen would be indicated and the exact cause of his symptoms need to be determined ------

Treatment is likely to extend beyond a single dose "cure" - It must be appreciated that symptoms may "disappear" without a cure being effected and follow up appointments should be kept even if one is feeling "better".

In conclusion please follow Sheryls excellent advice.

[mattk1]

Thank you for the replies!

Sheryl, thank you for the reply, your post is very informative but also a bit worrying for me. You are correct in your assumption of me trying to eradicate the dreaded G STD and I would visit the Red Cross clinic you mention right now if I could, the problem is I am 6 hours away from Bangkok. Is this the only clinic of its kind in the country? If so then I may get on the bus and visit anyway as I am very worried about this.

Jrtmedic, thank you also for replying to me. I would like a full checkup of everything for peace of mind and would really like expert help. I agree that self-diagnosis is hazardous but out of desperation I decided to continue. I am currently looking around for a similar clinic to the one sheryl mentioned.

Thank you again!

[Sheryl]

I don't know if the Red Cross has similiar clinics upcountry or nor. Where exactly are you?

[mattk1]

Hi Sheryl, it's ok I've found somewhere down the road from me that can carry out all the required tests. Thank you for your help!

[Sheryl]

You should also get tested for HIv in 3 months time. If you have not had the Hep B, be tested for the Hep B antigen at that time as well.

[marstons]

need to take a course of medication not a one hit or chances of it coming back are high, irrelevant of what it is. A one hit will not kill all bugs but most likely will make surviving bugs more resistant to treatment.

[Sheryl]

Some gonorrhea treatment protocols are one time doses.

The current CDC recommended treatment in the US is a single antibiotic injection. Not sure if this same regimen is effective in Thailand though as drug resistance is especiall ysevere here.

He should follow whatever protocol is recommended by a specialist in STDs.

[jrtmedic]

I believe this is the latest CDC advise for GC infection -(This advise ONLY applies to North America) which recommends a two drug approach which may extend over more than a one day treatment.

I have no current knowledge of resistance patterns or recommended antibiotic use in Thailand/Asia

"For patients with uncomplicated genital, rectal, and pharyngeal gonorrhea, CDC now recommends combination therapy with ceftriaxone 250 mg as a single intramuscular dose, plus either azithromycin 1 g orally in a single dose or doxycycline 100 mg orally twice daily for 7 days.

There are times, however, when it may be necessary to use an alternative antibiotic regimen that does not include ceftriaxone. In instances where ceftriaxone is not available, CDC recommends cefixime 400 mg orally, plus either azithromycin 1 g orally or doxycycline 100 mg orally twice daily for 7 days. For patients with a severe allergy to cephalosporins, CDC recommends a single 2-g dose of azithromycin orally.

In both of these circumstances, CDC recommends a test of cure for these patients 1 week after treatment, and this is an important change in CDC's treatment guidelines. In addition to these treatment changes, we encourage physicians to take 2 additional steps to ensure successful treatment outcomes for their patients.

First, monitor your patient for treatment failure. Patients who have persistent symptoms after treatment should be retested by culture. If these cultures are positive for the gonococcus, isolates should be submitted for resistance testing. A test of cure should be conducted 1 week after retreatment. Providers should also ensure that the patient's sex partners from the preceding 60 days are promptly evaluated and treated.

Second, report suspected treatment failures. Any suspected treatment failure should be reported to CDC through local or state public health officials within 24 hours.

It is important to know that a single 250-mg injection of ceftriaxone is effective in treating gonorrhea at all anatomic sites. There are no clinical data to support the use of higher doses of ceftriaxone. Also, the use of azithromycin as the second antibiotic used in combination therapy may be preferable to the use of doxycycline, for 2 reasons. First, azithromycin is taken as a single pill, which is easier and more convenient for a patient."

Dated Aug 12 2012

Edited January 27, 2013 by jrtmedic