[Question #7070] Concerns over encounter

9 months ago
Good morning doctors.  

I am a 32 year old male. At 10AM on Monday i haD unprotected oral and protected vaginal sex with a 49 year old woman.  About 8 hours later i took 1g of Zithromax and 400mg of Suprax.  The next morning i took an additional 400mg of Suprax.

I’ve had some sensation in my penis but I’m not sure if that’s just from my guilt and worry.  It’s been three days and i haven’t noticed any discharge or painful urination.  I haven’t had sex with my wife since and am worried about passing something to her.

My questions are:

1.  Is there a need for me to test?

2. Would these medications have prevented any bacterial STI from taking hold?  I worry i took the medication too soon, just 8 hours after the act.
 
Thank you.
Edward W. Hook M.D.
Edward W. Hook M.D.
9 months ago
Welcome back FORUM. This event sounds quite similar to your prior encounter (thread 6200) except that On this occasion, in addition to receipt of oral sex, you had condom protected vaginal sex as well. As long as condoms are worn throughout the encounter and the condom does not break, condom protected sex is safe, virtually no risk sex. I also note that the treatment you took was quite similar to the treatment you took on your last visit to the site as well. Thus many of my answers are exactly the same as before. 

I see no reason for testing for STI’s, including HIV at this time based on the events you describe.

There is no such thing as taking medication to soon following an exposure to prevent infection. 

In the unlikely event that your partner was infected, the combination of cefixime and azithromycin that you took would Almost certainly prevent gonorrhea chlamydia, NGU, and syphilis.

I hope this information is helpful. If anything is unclear or if there are further questions please do not hesitate to use you were up to two follow-up questions for clarification. EWH
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9 months ago
Thank you doctor, yes this encounter was with the same person.  After our previous encounter in October i was tested and negative.  She stills says she’s been with no one else besides her husband.  Given her age, marital status, and my history with her I’m inclined to believe my medication was a bit overkill.  But my fears and anxiety got the best of me.

I was worried because i see a lot online saying CDC doesn’t recommend Suprax any longer 

Would i he correct in thinking any sensations i may be feeling are likely anxiety driven? 

Edward W. Hook M.D.
Edward W. Hook M.D.
9 months ago
While suffixing is no longer formally recommended by the CDC, the combination of pacific seem and azithromycin would almost certainly prevent any infection that you might have. As I have discussed above the likelihood of infection is minuscule.

I agree with you as well that you are likely to be hyper – aware of normal genital sensations at this time and any sensations that you may note are likely the result of detection of otherwise normal sensations, not an STI.  EWH
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9 months ago
Thank you.  Finally, in the unlikely event that i was infected.  Would three days after taking the medication be sufficient to no longer be contagious towards my wife? Could i return to sex with her?

This is my final follow up,  thank you as always doctor for your support and insight.  This is a great service you guys provide. 
Edward W. Hook M.D.
Edward W. Hook M.D.
9 months ago
Yes, in the extraordinary event that had you been infected, three days after taking the medication you describe it is safe to assume that you were not infectious and that sex with your wife would not put her at risk.

Thanks for your thanks.  Take care.  EWH
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