[Question #10014] Unprotected exposure risk of STI infection and antibiotics

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26 months ago
I am a man had unprotected vaginal + oral exposure (give and receive) with a woman in her early 40's that I met when out at a bar on a business trip.  She seemed healthy and sane/normal and looked fit.   We had sex/foreplay for about an hour.  

I am concerned about exposure to STI, in particular Syphilis, Gonorrhea, Chlamydia and other STI.  I asked her status and she said she was clean (not sure how long ago tested) and I again asked after the fact.  I also understand the risk of HIV is very low. 

I had some antibiotics (AMOX-CLAV 875MG) that are 2 years old (never took them for sinus infection)  and took 1 dose 8 hours after the exposure and then another one 12 hours after that, I have enough for 10 days.  

Will taking the AMOX-CLAV so early help prevent any bacterial type of STI infection?  How many days/doses should I take this antibiotic as a precautionary measure (I want to be extra safe and can't get STI).   What was my exposure/risk to the STI's I mentioned or any other STI (assuming she had one?).  Will this antibiotic so early help/prevent?  
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Edward W. Hook M.D.
26 months ago
Welcome to our Forum and thanks for your questions.  This was a low risk event.  Most women do not have STIs and even when they do, the risk for infection from a single exposure is less than 20%.  In addition, your amoxicillin would prevent about half of Gonorrhea infections if exposed, most chlamydia and all syphilis after 6 or 8 doses. 

You don’t say how long ago this exposure was.  If there are no symptoms 3-4 days after stopping antibiotics, I would not worry.  Testing in this situation is optional and if you choose to test for your own peace of mind, please wait until 4-5 days after taking your last dose of antibiotics.

I hope this perspective is helpful.  EWH 
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26 months ago
Dr. Hook,

Thank you for your quick response!

The exposure was yesterday and so far I took two pills of the AMOX-CLAV 875MG.  I took 1 pill 8 hours after the sexual exposure and then another one 12 hours later.  For my peace of mind, I will take 8 doses total then (which is 4 days (8 pills) total) if this will reduce chances of gonorrhea, chlamydia and eliminate any risk of syphilis.   

Yes, I was concerned but I did ask the woman if she was recently tested and she said yes, she also said she never had an STI.   On another note, I have had oral herpes (HSV-1) since I was a child (but no breakout's since then), does this decrease my risk of being infected with HSV-2 (genital herpes)?  

   
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Edward W. Hook M.D.
26 months ago
Thanks for the additional information.  

You’re having HSV-1 slightly reduces your already low chances of getting herpes.  As an FYI, if you were going to experience an initial outbreak of herpes, it would occur within 8-10 days of your exposure.  EWH 
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26 months ago
Hi Dr.

It has been 8 days since the exposure, ironically enough I have some slight burning not he head of my penis/foreskin (uncircuised).  However, it appears as a fungal infection (I get recurrent fungal infections sometimes within a day of having sex and sometimes just from no where or too much running/working out).  I have a prescription for Fluconazole 150 (since I get 3 to 5 fungal infections of penis head/foreskin a year) but it seems mild so I just put on some 1% antifungal cream.  I am also having sold cold symptoms but more in sinus pressure (some family members were sick recently and we spent time together last weekend).  

I hope it's not a genital herpes outbreak.  If it is, would it be normal for the foreskin to be little red/inflamed and head of penis a little red in some spots?  generally that's how fungal infections appear when I have them.  Maybe I am overthinking...  Also, the antibiotic might have contributed to this fungal infection, but I stopped taking them Saturday.   

Thank you.
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Edward W. Hook M.D.
26 months ago
I agree that your symptoms sound more consistent with a fungal infection than a HSV recurrences.  Certainly antibiotics do increase your risk for developing a fungal infection and it sounds like you are pre-disposed.   When herpes recurs it typically follows the same patterns with each recurrence.  

As you know, we provide up to three responses to each client's questions.  As this is my 3rd response, this will complete this thread.  EWH
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