What treatment should I take for slightly swollen testicles with mild discomfort after completing a 3-week course of azithromycin (Zithromax) for chlamydia?

Management of Swollen Testicles After Chlamydia Treatment

You should seek medical evaluation for your testicular swelling as it may represent epididymo-orchitis, a potential complication of chlamydia that requires appropriate assessment and possibly additional treatment.

Understanding Your Current Situation

• You've completed a 3-week course of azithromycin (1g weekly for three weeks) for chlamydia infection 1
• Most of your initial symptoms have improved (penile pain/burning, pubic pimples) 2
• New symptom: slightly swollen testicles with mild discomfort but no pain 2

Possible Causes of Your Testicular Symptoms

• Epididymo-orchitis: A potential complication of chlamydial infection that can develop even after treatment has begun 1
• Incomplete treatment: While azithromycin is highly effective (97% cure rate), some cases may require additional treatment 1
• Reinfection: If sexual partners were not treated, reinfection could occur 2
• Treatment failure: Though uncommon with recommended regimens (0-3% for males), it can happen 1

Recommended Next Steps

1. Medical evaluation is necessary - Testicular swelling requires proper assessment by a healthcare provider 2

2. Do not self-medicate with ceftriaxone - This is not a standard self-administered treatment and requires proper medical evaluation 2

3. Diagnostic testing may be needed:

   • Physical examination to assess the testicles and epididymis 2
   • Possibly urine testing to check for persistent infection 2

4. Treatment considerations:

   • If epididymo-orchitis is diagnosed, your provider may prescribe appropriate antibiotics 2
   • Oral antibiotics are typically sufficient for uncomplicated cases 2
   • Doxycycline 100 mg twice daily for 7 days may be considered if persistent chlamydia is suspected 2, 1

Important Considerations

• Partner treatment is essential: Ensure all sexual partners from the past 60 days have been evaluated and treated to prevent reinfection 2

• Sexual abstinence: Avoid sexual contact until you and all partners have completed treatment and symptoms have resolved 2

• Follow-up: Return for evaluation if symptoms persist or worsen after completing any additional treatment 2

• Testing for other STIs: Consider testing for other sexually transmitted infections that may cause similar symptoms 2

Common Pitfalls to Avoid

• Ignoring testicular symptoms: Testicular swelling should never be ignored as it can lead to complications including fertility issues 2

• Self-medication: Using antibiotics without proper medical guidance can lead to inappropriate treatment and antibiotic resistance 2

• Resuming sexual activity too soon: This can lead to reinfection or transmission to partners 2

• Assuming treatment is complete: Even though most symptoms have improved, the new testicular symptoms require medical attention 2