Anabolic steroids and STDs

Nurses General Nursing

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I had a pt who came in, tested positive for Chlamydia.. he got the usual Azithro 1g for Tx, he came back in for his f/u and his urine still tested positive for chlamydia.. Doc prescribed another round of ABT, however Pt swears up and down he took all the pills and that he was not with anyone, he did tell me he was taking anabolic steroids... for my own knowledge and curiosity.. does anyone know if steroids affect the treatment of illness? I'd imagine so, but I can't think of why.. I'm a newer nurse sorry if this is a stupid question it's just bugging me to know the answer

Specializes in PICU, Sedation/Radiology, PACU.

Has his partner been treated?

When asked about sexual Hx it was a one time thing with alcohol involved, when asked by Doc if his partner needed Tx he had said he didn't even know how to contact her.. to my knowledge & his "honesty" it was a casual encounter, I think hence he was doc adamant about not sleeping with anyone since his first round of tx.

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

You can still test positive for a period of time after treatment.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

How long after treatment did they do the test of cure? For that matter, WHY did they do a test of cure? It's not recommended unless compliance is in question, or during pregnancy.

In answer to your original question, steroids would not affect the test result. Testing less than 4 weeks after treatment WOULD, however.

He came in approx 15 days after abt was administered.. still complaining of burning while urinating.. When I say follow up, he did not show up for his initial follow up... but made a new appointment for the issue not getting resolved.. sent it off & today he got his second round of abt. I was not the initial triage nurse.. just treated when he came in the second time & today.. still pretty puzzled, since he seemed really insistent he hasn't been with anyone & took all the first round

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
He came in approx 15 days after abt was administered.. still complaining of burning while urinating.. When I say follow up, he did not show up for his initial follow up... but made a new appointment for the issue not getting resolved.. sent it off & today he got his second round of abt. I was not the initial triage nurse.. just treated when he came in the second time & today.. still pretty puzzled, since he seemed really insistent he hasn't been with anyone & took all the first round

If he took the antibiotics as prescribed, and has not had intercourse since treatment, then it was a false positive due to testing too soon after treatment, with chlamydia DNA still present.

Specializes in retired LTC.

Are you 1000% positive that he was taking his meds as prescribed - all of them and just not skipping doses to share?

I'm a skeptic - I always doubt the most obvious.

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
Are you 1000% positive that he was taking his meds as prescribed - all of them and just not skipping doses to share?

I'm a skeptic - I always doubt the most obvious.

Azithromycin for chlamydia is a one-time dose of 1 gram. Kind of hard to mess that up! :D

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Are you 1000% positive that he was taking his meds as prescribed - all of them and just not skipping doses to share?.

Yes, as Pixie mentioned - it's one dose - either as a powder, or four pills you take all at once.

The only thing I could see is if he vomited up the dose shortly after taking it (which happens quite frequently, at least amongst the teenage girls and pregnant women whom I treat), and didn't want to admit that he puked?

Specializes in retired LTC.

I was thinking Z-pac.

That's a good question. Steroids suppress your immune system. And antibiotics work with your immune system. But there is likely a different answer for why the treatment was ineffective.

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