Anaphylaxis probably induced by transfer of amoxicillin via oral sex

Abstract

We present a case of a possible amoxicillin-induced anaphylaxis in a sensitive woman triggered by an instance of oral sexual contact with a man who was taking amoxicillin-clavulanic acid treatment.To our knowledge, this is the first case reported of a suspicion of amoxicillin-induced anaphylaxis in a woman after a sexual contact with a man who was taking the drug, we hypothesised an oral drug transfer through semen.Studies about amoxicillin concentrations achieved in semen after a drug intake are scarce. There are few cases reported of hypersensitivity reactions induced by drugs transported in semen but we have found some concern in sensitive patients about the possibility of transference of allergens via sexual intercourse. As clinicians, we consider that it is important to be aware of the existence of this possibility both in the diagnosis and in the prevention of anaphylactic reactions.

Lessons from peculiar cases of anaphylaxis: why allergists should be prepared for the unexpected

“…There are only few reports of oral allergy syndrome and consequent generalized urticaria in drug-sensitized individuals, a few minutes after passionate kisses given by their partners who had previously used the drug particularly beta lactams (49,50). Foods (such as Brazil nut) can also penetrate into seminal fluid and induce after vaginal intercourse (51); seminal fluid can also carry antibiotics (such as amoxicillin) and trigger anaphylaxis in an amoxicillinsensitized woman after oral sex (52). Anaphylaxis after anal intercourse but tolerance after vaginal intercourse has been also described (53).…”