I recently have been using dating apps and about a week ago gave unprotected oral sex and had protected sex with a woman I met on there. This was the second time we had met and have done the same (oral and protected sex) about a month and a half ago as well.

A couple of days after our most recent sex she reached out and told me a past partner had told her they tested positive for gonorrhea and syphilis. Today, 6 days post potential exposure I went to the doctor and got a throat and urine sample. On top of that because it was an actual instance of potential exposure and the timeline for when I might have got it could be either instance described above, they prescribed doxycycline and gave me a 500mg shot of ceftriaxone. Now I have read online and in your other posts that Doxycycline should treat potential chlamydia and ceftriaxone can treat gonorrhea and incubating syphilis. 

My main questions are 

1. Am I correct in thinking that the throat swab 6 days post most recent exposure would be effective at catching both gonorrhea and chlamydia. The doxycycline is prescribed but if my test comes back negative which I assume it will as the exposure was for potential gonorrhea and syphilis I shouldnt need to take it.

2.Is the 500mg of ceftriaxone effective at preventing both gonorrhea and syphilis? If I got exposed to syphilis during the earlier (month and a half ago exposure) and was already past incubation but hadnt shown symptoms, would the ceftriaxone also take care of that or would I need to follow it up with a actual penicillin shot to handle the past incubation syphilis.

Thank you!

You were at very low risk despite the possibility your partner had gonorrhea or syphilis. Oral sex is inherently low risk and condoms are highly effective. That said, I cannot fault your doctor for treating you prophylactically. And you have correctly interpreted out previous comments about the effectiveness of doxycycline; and ceftriaxone is also effective. To your specific questions:

1. Oral chlamydia is very rare, despite conflicting information you can find online. Gonorrhea was much more of a risk. In any case, you can expect your throat test to be negative for both gonorrhea and chlamydia.

2. Yes, ceftriaxone is 100% effective in preventing gonorrhea and syphilis and for aborting early infection if in fact you caught either one. Doxycycline also is 100% effective against syphilis. You should not have a penicillin shot; there is no need.

You probably were not infected and likely not even exposed to gonorrhea, chlamydia or syphilis. In any case, you're now home free and need no further treatment or testing.

Let me know if anything isn't clear.

HHH, MD

Just to confirm I understand you correctly, the Doxy would take care of any Chlamydia, and the Ceftriaxone would take care of any gonorrhea/syphilis.

When you say early infection for the ceftriaxone, what does that mean. If lets say I had gotten exposed to the potential syphilis a month ago when I was with this same person, and it had already incubated would the ceftriaxone had been enough? Penicillin is only for really late stage syphilis as I understand it?

Thank you