Researchers launch antibiotic pill to slow down STIs if taken within 72 hours after s3x
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U.S. CDC to post draft guidance on the use of Doxycycline, an antibiotic pill to slow down STIs if taken within 72 hours after s3x
U.S. CDC to post draft guidance on the use of Doxycycline, an antibiotic pill to slow down STIs if taken within 72 hours after s3x.
As rates of sexually transmitted infections continue to skyrocket across the United States, a growing number of physicians are prescribing a commonly used antibiotic as a way to prevent chlamydia, gonorrhea, and syphilis infections.
Doxycycline is a class of medications traditionally used to treat bacterial STIs after someone has been infected.
Yet recent research suggests that one 200mg dose of the drug can be effective in preventing such infections among men who have sex with men if taken within 72 hours after unprotected sex.
This approach, called doxyPEP, has garnered so much attention that the U.S. Centers for Disease Control and Prevention is expected to post draft guidance for public comment in the next several weeks on how healthcare workers may deploy the preventative treatment, such as how many pills should go into a prescription or which people could benefit most from the drug.
“The number of syphilis cases in the United States are at its highest level in over 50 years. The nation needs new tools to prevent STIs,” Dr. Jonathan Mermin, director of CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention, said.
“CDC is working on formal clinical guidelines on the use of doxycycline as STI PEP and will be requesting public comment on the agency’s draft recommendations,” he wrote. “This step allows us to gather important input before finalizing guidance, and gives clinical providers, people affected by STIs, and partner organizations the opportunity to weigh in before our guidance is finalized.”
However, some local health departments already have their own recommendations for the use of doxyPEP to prevent STIs.
The San Francisco Department of Public Health released doxyPEP guidance in October.
In April, the California Department of Public Health released similar guidance for healthcare providers recommending doxyPEP to men who have sex with men or transgender women who have had at least one bacterial STI in the past 12 months.
“We have high rates of sexually transmitted infections in San Francisco, and we consider this to be one of the urgent public health issues that we face as a city. And so, we felt like there was an imperative to move forward with providing a framework for the safe and equitable use of this innovative new tool for sexual health,” said Dr. Stephanie Cohen, director of the HIV/STI Prevention Section in the San Francisco Department of Public Health’s Disease Prevention and Control branch.
“We knew that it would take the CDC some time to develop and release consensus guidelines. But we also knew that we had people in our community and providers who were prescribing doxyPEP, so we didn’t feel that we could wait,” she said. “We’re now not the only health department that has released guidelines. A growing number of health departments throughout the country are putting out guidelines as they also see the need for this in their community.”
Cohen noted that Seattle and King County in Washington state have also released guidelines on the use of doxyPEP to prevent bacterial STIs in men and transgender people who have sex with men.
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But not all of these local and state guidelines are aligned, she said, and there are some “subtle differences” emerging, especially when it comes to who is recommended to use doxyPEP. The hope is that any forthcoming CDC guidance can help settle those differences and clarify which people may be eligible.
“Right now, clinicians are learning from each other in real-time how to provide doxycycline as STI PEP,” David C. Harvey, executive director of the National Coalition of STD Directors, said in an email. He added that any guidance from the CDC will help “fill gaps,” provide direction to clinics and offer a framework for using doxyPEP for STI prevention.
“An increasing number of doctors are providing their patients with doxycycline as STI PEP, including many of the nation’s most renowned STI clinics. Doxycycline is a safe, inexpensive, well-understood drug, and the evidence it works as PEP for men and transgender women is well-documented and consistent across research,” Harvey wrote.
“Doctors recognize the urgency of the STI epidemic, which is why so many clinics are moving forward and so many bigger agencies are pressing CDC to provide them with the information they need to roll it out more broadly.”
DoxyPEP was found to be about 65% effective at reducing the incidence of gonorrhea, chlamydia, and syphilis in a recent study.
The participants — who all had a history of STIs in the past year — were randomly assigned to receive either doxyPEP or their usual standard of care without doxyPEP.
The study, published in April in the New England Journal of Medicine, was conducted at clinics in San Francisco and Seattle.
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