Taking the oral antibiotic doxycycline within three days after unprotected sex lowered the risk of sexually transmitted infections amongst those at increased threat.
Further research is required to evaluate this preventive technique among varied populations and assess the prospective dangers.
Sexually transferred infections (STIs), such as gonorrhea, chlamydia, and syphilis, have been on the rise nationwide. They disproportionally affect men who make love with males and transgender females. Left untreated, they can cause major health problems, such as brain, nerve and loss of sight problems, and infertility in women. Prophylactics can block numerous STIs. However prophylactics are not always utilized consistently or properly. Scientists have been exploring other choices for preventing STIs, especially amongst those at raised risk for duplicated infections.
Previous studies found proof that the antibiotic doxycycline, taken shortly after sex, may lower the danger of bacterial STIs amongst guys who make love with men. This approach is called doxycycline postexposure prophylaxis, or doxy-PEP. Some professionals have been concerned that preventive usage of prescription antibiotics could lead to antibiotic resistance. This may lower future alternatives for treating STIs and other bacterial infections.
Sexually transferred infections (STIs), such as syphilis, chlamydia, and gonorrhea, are increasing throughout the country, particularly impacting males who make love with guys and transgender women. Current studies suggest that post-exposure prophylaxis with doxycycline (doxy-PEP) could minimize the danger of these STIs in these high-risk groups.
A research study by scientists at UCSF and the University of Washington reveals that doxycycline post-exposure prophylaxis (doxy-PEP) can decrease the occurrence of certain sexually transmitted infections (STIs) by two-thirds in high-risk individuals. However, the research study also discovered a slight boost in antibiotic-resistant germs in the doxy-PEP group, suggesting a need to weigh the advantages of STI decrease against prospective antibiotic resistance.
Sexually transferred infections (STIs), such as chlamydia, syphilis, and gonorrhea, have actually been on the rise nationwide. Scientists have actually been checking out other alternatives for avoiding STIs, particularly amongst those at elevated risk for duplicated infections.
Previous studies found evidence that the antibiotic doxycycline, taken soon after sex, might decrease the threat of bacterial STIs amongst guys who have sex with men. The study registered 501 grownups thought about at high risk for bacterial STIs, either men who had sex with males or transgender ladies. Participants were checked for STIs every 3 months and followed for one year.
For more information, a group led by researchers at the University of California, San Francisco (UCSF) and the University of Washington, Seattle, set out to measure the security and effectiveness of doxy-PEP. They also tried to find evidence of antibiotic resistance. Outcomes were published in the New England Journal of Medicine on April 6, 2023.
The study enrolled 501 grownups considered at high danger for bacterial STIs, either males who made love with males or transgender ladies. All had been detected with a bacterial STI in the previous year and reported having sex without utilizing a condom in the previous year. They were either dealing with HIV or were preparing or taking to take medication to avoid HIV infection.
Participants were randomly appointed to receive either doxy-PEP or basic care. Those in the doxy-PEP group were informed to take a 200 mg doxycycline tablet as soon as possible within 72 hours after condomless sex. Individuals were checked for STIs every three months and followed for one year.
The researchers found that the doxy-PEP group had a two-thirds lower occurrence of syphilis, chlamydia, and gonorrhea compared to the standard-care group during each three-month time period. STIs were found in about 10% of the quarterly tests administered to those in the doxy-PEP group, compared to about 30% of those in the standard-care group.
Gonorrhea was the most typically identified STI. The incidence of gonorrhea per quarter in the doxy-PEP group had to do with 55% lower than in the standard-care group. Chlamydia and syphilis were each decreased by more than 80% per quarter.
The researchers discovered that the doxy-PEP group had a decently higher proportion of doxycycline-resistant Staphylococcus aureus living in the nose after 12 months. And the occurrence of gonorrhea stress resistant to the antibiotic tetracycline, which is in the exact same antibiotic class as doxycycline, was 38.5% in the doxy-PEP group compared to 12.5% in the group with basic care. This finding suggests doxy-PEP could be less reliable in preventing gonorrhea with existing tetracycline resistance; nevertheless, the variety of available gonorrhea cultures was low.
” It will be essential to keep track of the impact of doxy-PEP on antimicrobial resistance patterns with time, and weigh this versus the demonstrated advantage of decreased STIs and associated decreased antibiotic usage for STI treatment in males at elevated threat for reoccurring STIs,” states Dr. Annie Luetkemeyer of UCSF, a co-leader of the study. “Given its demonstrated efficacy in several trials, doxy-PEP must be considered as part of a sexual health bundle for males who make love with guys and transwomen if they have actually an increased risk of STIs.”
Recommendation: “Postexposure Doxycycline to Prevent Bacterial Sexually Transmitted Infections” by Anne F. Luetkemeyer, M.D., Deborah Donnell, Ph.D., Julia C. Dombrowski, M.D., M.P.H., Stephanie Cohen, M.D., M.P.H., Cole Grabow, M.P.H., Clare E. Brown, Ph.D., Cheryl Malinski, B.S., Rodney Perkins, R.N., M.P.H., Melody Nasser, B.A., Carolina Lopez, B.A., Eric Vittinghoff, Ph.D., Susan P. Buchbinder, M.D., Hyman Scott, M.D., M.P.H., Edwin D. Charlebois, Ph.D., M.P.H., Diane V. Havlir, M.D., Olusegun O. Soge, Ph.D. and Connie Celum, M.D., M.P.H. for the DoxyPEP Study Team, 6 April 2023, New England Journal of Medicine.DOI: 10.1056/ NEJMoa2211934.
Funding: NIHs National Institute of Allergy and Infectious Diseases (NIAID).
