Oral Sex

[unknown25476]

Dr.
Thank you in advance for your time.  About 3 days ago 3/17/09 I was involved with a random unprotected oral sex activity with a female at a bachelor party. As soon as  I realized how stupid I was being, I rushed to the bathroom and immediately washed with sanitation soap. I have no signs of any symptoms on my penis.  Yesterday 3/20/09 I was prescribed clarithromycin er 500 for 7 days for a sinus infection.   After reading a lot on the internet it appears that EVERY STD can be obtained through oral sex which I was not aware.  If I were your patient, what advice would you recommend?  Will the anti biotic prescribed for my sinuses deal with any bacterial std I may have caught or could it suppress the symptoms?  Should I be really concerned about spreading something to my girlfriend?  Should I be tested, if so how long should I wait?

[Edward W Hook, MD]

Ah ha, another instance of internet mis-information.  Oral sex is an inefficient way to transmit STDs.  Of the bacterial STDs only gonorrhea and nongonococcal urethritis (NGU) are transmitted through oral sex; chlamydia is not and without an obvious sore or lesion on your partner’s mouth, the chances of syphilis and herpes is likewise tiny.   If you had gotten gonorrhea or NGU you would have most likely developed symptoms of urethritis (penile infection).  Even if your partner had an STD (any STD and it is likely she did not), most exposures do not lead to infection.  In your case, you had a single exposure; I would urge you not to worry.  Furthermore, the clarithromicin you have taken would cure NGU and most but not all gonorrhea in the unlikely situation that you got either of these

As for viral STDs including HIV, the risk for HIV from oral sex is close to zero, all things considered and is not worth worrying about   The risk of herpes from oral sex is low unless your partner had a cold sore and even then the risk is low.  

If you are concerned, at this time you could go to your local STD clinic or health care provider to be tested at this time.  The tests will be negative and in my opinion, you do not need testing at all.  Hope these comments help.  EWH

[Edward W Hook, MD]

The clarithromycin would be preventative.curative for sure for chlamydia and NGU and probably work for gonorrhea and syphilis although there may be occasional (rare) problems with them. EWH

[Edward W Hook, MD]

You did not have any reason to be conerrned of an STD before and ahve even less reason at this time.  The dribbling you describe would not be a symptom of either the antbiotics you are taking or an untreated STD.  At this time this is something for you to deal with with your own docotrs.  EWH

[unknown25476]

Since our last post, not only was  on clarithromycin for 10 days, I was on doxycycline 100mg for 7 days for infected fire ant bite.  While on Doxycycline I started to feel urgency to urinate and some dribbling after urination.  (I was diagnosed last year for prostititis after being tested for bacterial std's.)  I called my urologist and he suggested I go on cipro 500 twice a day for ten days.  The symptoms of urinating and dribbling have not subsided.  Could these symptoms be an std after the antibiotics I have been on?  I cannot get an appontment untl next week with my urologist.  Any suggestions?  Any std worry since from your very first post you confirmed std from unprotected is low?


Thanks Dr.  I assure you this is my last post.

[unknown25476]

I appreciate your help!  The only other question I have in about the Clarithromycin.  In some post it suggest that it can cure/prevent chlamydia,gonn., NGU and syphillis then in others it suggest that it cannot.  If I started taking the meds a day after the exposure am I safe from all bacterial stds or can it suppress the symptoms?

Thank You!