[Question #6778] Cefixime + Azi

65 months ago

Dear doctors,

I tried to go through other threads but didn't feel 100% sure about a possible answer to my question.

Exposure: 21 days ago, while very drunk I had two contacts with massage women (they are in an are of the country where I'm based that implies mid/high price). Both of them was unprotected oral and protected insertive vaginal sex. From what I've read, condom breakage would be obvious and then I'm quite sure that didn't happen. This happened on a Saturday night (around 2am).

Monday after I freaked out because I have a regular partner and took 800g of cefixime and 1g of zhitromax. I understand from what I've read that this wasn't smart as being self treatment but I didn't know what to do as testing wouldn't be possible anytime soon..

Since then I haven't had any discharge or lesions. Sometimes it can happen that my penis is moisture in the morning but I just assume that's from wanting to urinate or maybe some kind of precum during the night? It doesn't really show up anything else throughout the day.

So my question is pretty straight forward. Is there anypoint in being concerned at this moment given the timeframe or should I just put this behind my back and continue with my normal life? Thank you for your time.

Edward W. Hook M.D.

65 months ago

Welcome to our Forum. Thanks for your question. I’ll be glad to comment and will provide a generalized estimate of your risk. The encounters you describe were not no risk but the risk was small. Having said that the only way to be completely sure you were not infected is to test.---

65 months ago

Hi doctor,

Thank you for your prompt reply. I wonder why is your comment so generalized (please do not see this in a bad way)?

The reason I am asking it is because I read many posts where both you and Dr H comment saying that having taking this medication there's not much point in testing as the medication would have prevented/cured a possible infection... I'm really lost with your comment.

Sorry again, but just really concerned about my regular partner and not intending to be disrespectful. Hope you understand.

Edward W. Hook M.D.

65 months ago

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Edward W. Hook M.D.

65 months ago

I’m sorry. Only part of my response was transmitted. Given the nature of your encounter and the fact that you took antibiotics it is most unlikely that you acquired and STI from the exposure you described. Facts that were not transmitted in my original reply are:

1. Most commercial sex workers do not have STI’s.

2. Even if one of your partners had an STI, most exposures do not lead to transmission of infection.

3. Use of condoms throughout your vaginal sexual encounters makes those encounters virtually no risk as long as the condom was worn through out the sex act and did not break. There appears to be no reason to be concerned that your condom may have broken.

4. The risk of acquiring STI’s from receipt of unprotected oral sex is lower than the risk of acquiring STI’s from unprotected vaginal sex. Relatively few STIs Are transmitted through receipt of oral sex.

5. The combination of antibiotics that you took would be highly effective for curing gonorrhea, chlamydia, syphilis, and NGU. These are the most common STI’s which your encounters would put you at risk for. These antibiotics would also obscure the results of testing in the week or two following taking them.

6. If you were going to develop symptomatic genital herpes from this exposure, you would have had an outbreak by this time. There is no reason to continue to worry about the possibility of herpes.

7. The sex acts that you describe did not put you at risk for HIV.

8. The early morning moisture that you describe is not suggestive of the presence of an STI.

It sounds as though you are unable or unwilling to pursue testing. If that is the case, my advice is to put these episodes behind you and move forward without continuing concerns. Capital EWH

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65 months ago

Hello Doctor,

Thank you again for your reply and I apologize if I came across somehow impatient. Your answer def put my mind in a better place and I would like to take advantage of having more replies just to clarify a few things - I hope I don't seem to be overthinking.

4. I am not 100% about the exact timeline but I had oral sex with my regular partner with ejaculation in her mouth which wasn't spit out. However, it would have been at least 50h+ after taking the cefix+azi. In the event of being infect, could I have infected my partner with anything (if yes would this only be in her throat or could travel and give her vaginal symptoms)? Sorry if this is a no sense question.

There hasn't been any vaginal intercourse between my partner and I tho.

8. Today I woke up and again had some moisture/maybe a bit thick "discharge" at the tip of my penis. Woke up full erected and full of urine. Please note that throughout the day this doesn't really happen and I don't have any burning sensation urinating whatsoever. Not trying to be repetitive, but thought was worth mentioning as I felt it this morning.

Regarding testing, unfortunately given the world wide pandemic I'm self quarantined with my partner at home and am not going to be able to leave for the next 10 days and that's why I decided to post here. Difficult moments that just put the anxiety more up the roof.

Once again thank you for your support.

65 months ago

4. Just an update on this one. In case it happened this early, it was 54h+ having taken the antibiotics. I read in a recent post where you say that after taking Azi people aren't infectious after 2-3 days. Don't know if having also taken cefi 800g puts me in a safer place for being basically 2.25days. Anyway, I will wait for your response now. Thank you.

Edward W. Hook M.D.

65 months ago

In follow-up:

4. Even if you had been infected, your partner would not be at risk by performing oral sex on you more the48 hours after taking the medications.

8. I suspect you are looking for signs of infection more closely than you would normally. Thus it is not unusual to observe things that would have normally been overlooked. Is sort of nocturnal moisture is not unusual. I would not be concerned in any way unless it was occurring throughout the day.

4. You’ll be fine.

EWH

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65 months ago

Thank you for your response. Given your advice I will put this mistake behind and keep moving with my life.

I would like tho to ask a more general question that perhaps could also help people in the future. Two days ago, my partner and I resumed vaginal intercourse after 1.5month. After we finished and when cleaning herself, blood stained the toilet paper but it never came out during the actual intercourse. The day after the same thing happened, but not as much. What could this mean? I know it is a general question but just to understand if it could be related to an STI because internet can be misleading sometimes and I would prefer to hear from you. This is not a question regarding my recent exposure, but I would like to my last reply to ask regarding my partner's health and perhaps help people in the future with the same question.

Thank you for your help and take care.

Edward W. Hook M.D.

64 months ago

The sort of vaginal blood that you describe is best referred to as "spotting". It is non-specific. Rarely it could be due to the presence of an STI but there are many other causes including lack of lubrication, etc. If it continues it may be worthwhile for your partner to be checked out but given the nature of your exposure and the antibiotics you took, it is unlikely to be related to the misstep you describe in your original question.

As you know, we provide up to three responses to each question. This response will complete this thread. Take care. EWH

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