[Question #8625] Antibiotics course and syphilis testing
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41 months ago
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Hello. This question is not about risk assessment.
In my last interaction here I described an event where I had insertive (received) oral sex with another guy. You advised to just wait to see if symptoms arise and to not test otherwise. I have had no symptoms after 11 days, so all good. I still planned to test for syphilis after six weeks, since it is quite a serious disease if left untreated.
However, last week I had throat problems and my doctor found strep bacteria so yesterday (10 days after the sexual contact) I started a course of 5 days on Amoxicilin, 1 gram orally every 16 hours.
My question is: how can this impact testing for Syphilis? Should I still test after 6 weeks normally, or this antibiotic course would make the testing unreliable?
Thanks in advance, and sorry for the new question. You are by far more knowledgeable than my doctor in these matters and I really value your opinion.
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H. Hunter Handsfield, MD
41 months ago
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As discussed previously, the chance of syphilis from this exposures was very low, although not zero. Amoxicillin in that dosage probably would abort incubating syphilis, preventing it from ever becoming active. However, it might only suppress the infection, delaying symptoms (which might show up as long as 3-4 weeks after completing amoxicillin) and also delay a positive test result. Assuming no symptoms, you could have a syphilis blood test 3 months after completing amoxicillin -- a negative result at that time would be conclusive.
If you have a way to contact your sauna partner, another option is to explain the situation to him and ask him to be tested for syphilis. If negative, you would know you were not exposed and no testing would be necessary.
---HHH, MD
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41 months ago
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Unfortunately I have to way to contact the sauna partner.
So, assuming the amoxicilin suppresses the infection but doesn't stop it, should I still expect symptoms (i.e. chancre on penis) to appear in case I am infected? Also, would you recommend me to stop any sexual activity (in absence of symptoms) until I get tested for syphilis in 3 months?
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H. Hunter Handsfield, MD
41 months ago
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Possibly you would develop a chancre, but not necessarily.
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All things considered, the chance you have syphilis is exceedingly low. If you're speaking of continuing sex with a regular partner, and if I were in your situation, I would continue unprotected sex with my wife without worry. But if you're speaking of new partners, it would be best to hold off -- or be prepared to inform them of the situation and let them decide whether or not to proceed with sex.
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41 months ago
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Ok, all clear, I will hold off having new sexual contacts until I get tested, but in the meanwhile I will assume I don't have syphilis unless proven otherwise. Thank you very much.
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H. Hunter Handsfield, MD
41 months ago
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Just to be clear, the chance you were exposed to and infected with syphilis was low to start, and with the treatment, even lower. I would guess the chance you have syphilis and could infect a partner to be under 1 chance in a million. If you're not willing to take even that risk, then your plan is the right one.
Best wishes and stay safe.
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