This is great topic for ripe discussion. There is a lot of literature out exploring DoxyPrEP but there are no clear guidelines or recommendations. The major concerns have been what is the appropriate dose, dosing schedule, is is pre-exposure or post-exposure. I totally respect the concern for antimicrobial resistance, but there has been decades of use of daily doxycycline and there hasn't been any clinically significant evidence of resistance in
C. trachomatis or
T. pallidum., my concern would be increasing tetracycline resistant MRSA, but honesly how may of use are using doxycycline as first line for an MRSA infection. Below are some weblinks for reference.
https://www.croiconference.org/abstract/demand-post-exposure-prophylaxis-doxycycline-msm-enrolled-prep-trial/https://clinicaltrials.gov/ct2/show/NCT03709459 - Clinical trial in Australia, worth following for updates
https://academic.oup.com/cid/article/70/6/1247/5557867 2019 article in CID
Overall I am not opposed to it and have discussed with a few patients I feel are good candidates.
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Quintin Robinson
Absolute Care Medical Center & Pharmacy
Atlanta GA
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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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