After French kissing a random stranger at a club, should I go to the emergency department for antibiotics?

No, You Do Not Need to Go to the ER for Antibiotics After Kissing a Stranger

Kissing a stranger at a club does not require emergency department evaluation or antibiotic treatment. There is no indication for prophylactic antibiotics in this scenario, and seeking emergency care would represent inappropriate antibiotic use that contributes to antimicrobial resistance 1.

Why Antibiotics Are Not Indicated

No Bacterial Infection Present

• Antibiotics should only be used to treat confirmed or highly suspected bacterial infections, not for prevention after casual contact 2, 3
• The guideline principle is clear: avoid using antibiotics to "treat" potential exposure—use them only when there are clinical signs of actual infection 2
• Kissing, even with a stranger, does not constitute an exposure that warrants prophylactic antibiotics 1

Inappropriate Use Causes Harm

• An estimated 142,500 ED visits occur annually for adverse events from antibiotics, with nearly 80% being allergic reactions 4
• The risks of unnecessary antibiotic use include allergic reactions, Clostridium difficile infection (causing 29,300 deaths annually), and promotion of antimicrobial resistance 1
• Inappropriate antibiotic prescribing is the most important preventable cause of drug resistance 1

What You Should Actually Do

Monitor for Symptoms

• Most respiratory infections transmitted through close contact are viral and self-limiting 5
• Watch for development of specific symptoms over the next 7-14 days, such as:
  • Persistent fever >38°C for more than 3 days 5
  • Severe sore throat with difficulty swallowing 1
  • Respiratory symptoms that worsen rather than improve 5

When to Seek Medical Care (Not the ER)

• If you develop symptoms suggestive of streptococcal pharyngitis (severe sore throat, fever, swollen lymph nodes), see your primary care provider for testing before any antibiotics are prescribed 1, 5
• For respiratory symptoms, antibiotics are only indicated if fever persists beyond 3 days or specific criteria for bacterial infection are met 5
• The ER is not the appropriate setting for this concern—it contributes to ED overcrowding and inappropriate antibiotic stewardship 4

Common Pitfalls to Avoid

• Do not request antibiotics "just in case"—this practice drives antimicrobial resistance and exposes you to unnecessary medication risks 1
• Patient pressure for antibiotics should not influence prescribing decisions; clinical criteria must guide treatment 5
• The vast majority (>90%) of acute respiratory infections are viral and resolve without antibiotics 5