[Question #10528] Advise after oral
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22 months ago
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I male performed unprotected fellatio on another male of unknown status (verbally said they were clean). A small amount of semen did get in my mouth but I spit it out right away. About 35 hours after the incident I took 500mg of oxytetracycline prophylactically. I know the exposure is relatively low risk. Did the antibiotics help my chances of not contracting Chlamydia, gonorrhea, and syphilis? If this is a one time exposure (not my thing) would you recommend testing? (I had a full panel done before this - all negative). If so what would be the recommended timeline?
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Edward W. Hook M.D.
22 months ago
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Welcome to the Forum. Thanks for your questions. The exposure you describe was relatively low risk- most persons do not have STIs and most exposures do not result in infection, particularly in the oral cavity. Your chances of infection are low and the antibiotics you took make your risk lower still as explained below.
The tetracycline you took following your exposure is essentially what is now referred to as "doxy-PEP" (i.e. doxycycline Post-Exposure Prophylaxis) which has been proven to reduce the incidence of syphilis, chlamydia and, to a lesser degree (about half as much as the reduction in chlamydia or syphilis because gonorrhea is more likely to be resistant to tetracycline antibiotics than syphilis or gonorrhea). Most of the infections prevented in these studies occurred in the ano-genital region but it likely would some effect at the throat as well.
My sense is that the likelihood that you were infected is quite low and I do not feel strongly that testing is needed but testing is always a person decision. I cannot guarantee that you were not infected but the chances that you were is quite low.
I hope that this information is helpful to you. EWH
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22 months ago
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Thank you for the quick reply. I think for the piece of mind I will end up testing. Since the antibiotic was taken how long would you recommend waiting to test for an accurate result?
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Edward W. Hook M.D.
22 months ago
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Testing any time more than 36-48 hours after taking the doxycycline will be accurate- the drug will have entirely left your system but then. EWH---
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22 months ago
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Ok. But trying should wait until 3-6 weeks after exposure?
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Edward W. Hook M.D.
22 months ago
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It depends on what you are worried about. Testing for gonorrhea or (most unlikely) chlamydia will be accurate any time more than a few days after your exposure and 36-48 hours after taking the antibiotic. Syphilis is rare if you did not see or feel a lesion on your partner and the antibiotic would have prevented it if exposed. I see no benefit to waiting 3-6 weeks to test.
As you know, we provide up to three responses to each client's questions. This response will complete this thread which will be closed shortly. EWH
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