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Odd prescription for gonorrhea
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Odd prescription for gonorrhea

I performed oral sex on another male in a gay men's sauna, so a high risk interaction. I went to put a condom on the man, touched it against his penis, realised I was trying to put it on the wrong way, then corrected and slipped it on him.  Potentially it may have had a dab of fluid on it at this point - I'm not sure. I then took him in my mouth (with condom on) for a few minutes, but not to climax. We also masturbated each other, but not to climax, instead finishing ourselves off. Five hours after this exposure, guilt got the best of me and I went to a doctor.  Doctor said most likely chance, if anything, was Gonorrhea or less likely syphilis, though I observed no sores on the man.  Doctor then prescribed 2mg (4 capsules) of something called Cephalexin to be taken immediately (I did) followed by 4 x 500mg per day for five days.  In my web research of Gon. and Syph i can't see any professional body propose this prescription as an option!  Should I seek alternate advice, or is this ok? I do feel like I have a sore throat now, even after 3 days of this antibiotic regime.
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Welcome to the forum.

First, based on your description, the risk of any STD is low.  Although receptive oral sex indeed carries risks for gonorrhea and syphilis, the odds of infection from any single exposure are very low.  Personally, I would not have prescribed treatment, but this is a judgment call and I can't fault your doctor for doing that.

Second, you are correct that the treatment prescribed is atypical. However, it is likely to be effective in preventing both gonorrhea and syphilis.  Cefalexin (trade name Keflex, and generics) has fairly strong activity against gonorrhea and probably against syphilis; and you were prescribed a high dose.

Your sore throat is unrelated to the exposure described, unless you happened to catch a cold from him.  (Oral/throat gonorrhea rarely causes sore throat or other symptoms; most cases are asymptomatic. And syphilis doesn't cause sore throat at all; and the incubation period for initial syphilis is 10-20 days.)

So at this point you have no worries.  No further treatment is needed, and there is really no need for testing.  Neither gonorrhea nor syphilis was likely, and if you indeed were exposed, the treatment would have aborted either infection.  However, if it will help your confidence you weren't infected (or that the treatment was effective), you could have a throat culture for gonorrhea and a syphilis blood test in about 6 weeks.  If you do so, you can definitely expect negative results.

I hope this helps.  Best wishes--  HHH, MD
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