STAT – The Centers for Disease Control and Prevention finalized its guidelines for post-exposure prophylaxis against bacterial sexually transmitted infections on Tuesday.
For groups at higher risk of contracting syphilis, chlamydia, and gonorrhea, the agency now recommends taking doxycycline, an antibiotic, within 72 hours of having sex.
Doxycycline has been used to prevent malaria infection both before and after exposure, but this is the first time the antibiotic has been used prophylactically against STIs.
“Doxy PEP represents the first new STI prevention tool in decades, at a time when innovation in the nation’s fight against STIs is desperately needed,” the CDC wrote in the guideline announcement.
The spread of syphilis in the United States in particular has been cause for concern in recent years, as cases reach levels unseen since the 1950s.
The CDC spends about $160 million per year fighting sexually transmitted infections, nearly all of which could be prevented by moral behavior. – HEADLINE HEALTH
The policy, which was proposed in October 2023, is based on evidence from three large randomized trials showing that a 200 mg dose of doxycycline, taken after potential exposure to sexually transmitted bacteria, reduced chlamydia and syphilis infections by more than 70%, and cut gonorrhea infections in half.
[So about 30% of chlamydia and syphilis infections will still occur, along with half of gonorrhea infections. And the CDC thinks this is a good thing? – HEADLINE HEALTH]
While effects against gonorrhea may be limited, and further interventions such as vaccines may be indicated, the prophylaxis has a chance of controlling the spread of chlamydia and syphilis, said Connie Celum, a professor of global health, medicine, and epidemiology at the University of Washington.
“I think the big question now is just who adopts that? Are we able to reach the people who are at highest risk? And how well do they use it?” she said.
Watching consistency and uptake, particularly as more providers begin prescribing doxycycline, will be essential to understand whether the intervention can have an impact on population health …
