Giving unprotected cunnilingus risk?

[gromiticom]

Hello.  I'm 48 year young male, and  I gave unprotected cunnilingus to 2 different lady friends (they may be escorts, but i'm not sure yet) I met recently at a couple of rock shows.  The first time was a few days ago, and the second time this morning.  They seemed well dressed/groomed and clean, but I guess one never can tell.  I gargled with Listerine following both.   I am now all nervous about these 2 encounters, and want to 'change my ways'!   Is my risk factor for aquiring an STD high?  I have a vial of 5 unused 500mg Amoxicillin capsules that expire on 12/7/2010 (this year).  Should I take them as a precaution to kill any STD's I may have picked up, and if so, what dose?  Thank you.

[Edward W Hook, MD]

The problem with your taking amoxicillin at this time is that a substantial portion of gonorrhea are now resistant to amoxicillin and if you were going to take the amoxicillin you would need to take at least 3 grams, along with a second medication to boost the antibiotic levels in your blood.  As I said before, I do not recommend taking amoxicillin.

The chances are that you did not get infected.,  Personally I would not worry but if I could not control my concerns, I would get tested, not take an antibiotic which might or might not help.  

It is, of course, up to you.  EWH  

[Edward W Hook, MD]

Welcome to our Forum. These were low risk exposures.  Statistically it is unlikely that either of your partners had an STD.  Furthermore, oral sex is an inefficient way to transmit STDs.  Of the bacterial STDs only gonorrhea is acquired through oral sex; chlamydia is not and without an obvious sore or lesion on your partner’s genitals, 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.

There are no data to tell us whether or not your use of listerine would have had any effect on what small risk there might have been from this exposure.

There is really no benefit from taking the amoxicillin you have.  If you are concerned get a throat culture or nucleic acid amplification test (increasingly used instead of culture) for gonorrhea.  No other testing is needed.  I hope this comment is helpful.  EWH

[Edward W Hook, MD]

the other processes you mention are not STDs.

Time for this thread to end.  EWH

[gromiticom]

Can one catch anything else other than STD's (such as the flu, cold, yeast infections, etc.) from performing cunnilingus?  Just curious.

[Edward W Hook, MD]

No.  I would consider other causes.  EWH

[gromiticom]

It's been several days now since my exposures, and my throat was a bit sore last night, and i've now got lots of phlegm and productive mucus, and it feels like the bottom of my lungs are tender with a little pain when I cough.  Could these symptoms be an STD related to this exposure?  Thanks in advance.

[gromiticom]

Thank you for the prompt response Doctor Hook.  This convenient and efficient online service you all provide is a 'godsend', and quite invaluable.  Many of my fears and concerns have been allayed, but if I do decide to take a single large dose of Amoxicillin (like the typical dose some patients take prophylactically before seeing a Dentist of oral surgery), would this specific drug be enough to wipe out any beginning phase of throat Gonorrhea, IF I was indeed infected?  If the Amox is effective against early stages of Gonorrhea, it sounds logical (in my opinion) to take it in order to insure 'peace of mind' now, instead of going to get tested, then having to await the results.  This will be my last post, and again, thank you for all you do!  Enjoy the rest of the summer, and upcoming fall weather...