I agree with Dr Shalit, antibiotic resistance is my biggest concern -- a few years ago, the Philadelphia Health department got the data out of Seattle and the health department head at the time, Dr Farley, went on a mission to get us all to prescribe doxyPrEP for HIV pos MSM who had a history of syphilis. I mean, big push. Like had a meeting with our office and everything. we MIGHT have 2-3 patients on in the whole practice but largely, it did not catch. I havent seen/heard of new data. Maybe CROI will have something this year other than COVID?
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Angela Kapalko
Physician Assistant Chairperson for AAHIVM
Philadelphia FIGHT CommunityHealth Centers
Philadelphia PA
akapalko@fight.org------------------------------
Original Message:
Sent: 02-02-2022 15:36
From: Peter Shalit
Subject: Prophylactic doxycycline for STIs?
There was a study presented a CROI several years ago - the last time CROI was in Seattle I believe. DoxyPrEP did well at preventing chlamydia and syphilis but had no effect on gonorrhea acquisition. I am wary to encourage more antibiotic resistance by having lots of sexually active people on daily doxycycline, because we are running out of treatments for STIs. I did agree to one patient doing "DoxyPEP" since his encounters are relatively infrequent and he is doing on-demand Truvada for PrEP. He is taking a couple days' worth of doxycycline after an encounter. I'm not aware of data for this though.
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Peter Shalit
Dr. Shalit's Office
Seattle WA
Original Message:
Sent: 02-01-2022 17:47
From: Ashwin Gupta
Subject: Prophylactic doxycycline for STIs?
** BUMP **
Hi all, I would really like to have a larger discussion on this subject!
I feel ill prepared -- and, I have had a few patients.. well, wait, that's a lie - one patient -- who is currently on TDF/FTC for HIV PrEP, well tolerated, asking about qD proph with doxycycline.
I'm in Philadelphia, and I have not yet connected with other HIV providers regarding the subject.
I desire to see/study/review the studies and evidence. After a short brief scour, I saw UK and AUS studies. Knowing it's alt tx for Treponema, and 1st line for tx of C.t., I would like to know it's efficacy through prophylaxis. Any links, advice, and comments would be super helpful!
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Ashwin Gupta
Philadelphia PA
Original Message:
Sent: 04-06-2020 16:16
From: Tiffany Townsend
Subject: Prophylactic doxycycline for STIs?
Hello,
Is anyone using doxycycline as prophylaxis for syphilis and CT? I have one gentleman this may benefit, but haven't yet taken the step.
Your thoughts?
Tiffany L. Townsend, MS, FNP-C, AAHIVS
Pronouns: She/Her/Hers
Maine Medical Center/Maine Medical Partners
Gilman Clinic
48 Gilman Street
Portland ME 04102
207.661.4400 (phone)
207.662.6116 (fax)
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