A new study Published in New England Medicine newspaper It raises concerns that Doxy PEP, a strategy of taking medications to prevent sexually transmitted infections (STIS), can already contribute to the rise of antibiotic -resistant bacteria.
While this is something that public health experts are concerned about when Doxy Pep is first recommended by the CDC centers in 2024, no one advises people to stop using it. Most experts still believe that Doxy Pep is a valuable tool for preventing Sti.
What is Doxy Pep?
Doxy PEP (after the DoxyCycline exposure) is a Sti Prevention Strategy that includes taking a dose of antibiotic doxycycline after countless oral or anal sex. In men who have sexual intercourse with men and women transsexuals who have sex with men, Doxy Pep has been shown to reduce syphilis and chlamydia by about 80% and gonorrhea by about 50%.
So far studies have not found the Doxy Pep to be effective for women who have vaginal sex.
Doxy Pep is intended for adult men who have sexual intercourse with men and transsexual female sexual intercourse with men – especially those who had Sti last year. Healthcare providers can also suggest it to people in this community that have more than one partners.
The increasing threat of antibiotic resistance
Bacteria that cause infections are constantly evolving. Over time, some develop the ability to combat the antibiotics they worked against. This is called antibiotic resistance. When a bacterium develops antibiotic resistance, fewer antibiotics are effective against it. Medicine -resistant versions of bacteria can pass from person to person and cause infections that are more difficult to cure.
The bacterium causing gonorrhea-Neisseria gonorrhoeae– It is very good to resist the medicines we have developed to deal with. As early as the 1940s, Neisseria gonorrhoeae It was resistant to sulfanilamides. Until the 1980s it was resistant to penicillins and tetracyclines. In 2007, the CDC stopped to recommend fluoroquinolones, leaving only cephalosporins as an effective treatment against this Stir. Experts believe that this existing resistance can explain why Doxy PEP is less effective in prevention of gonorrhea than in the prevention of chlamydia and gonorrhea. (Doxycycline is tetracycline.)
Excessive use of antibiotics in both health care and supply has contributed to the development of antibiotic resistance. Some scientists were concerned from the beginning that the use of antibiotics to prevent a possible infection and not to treat an active infection could increase medication resistant bacteria.
New Studies and the impact of Doxy Pep
Researchers at Harvard School of Public Health studied more than 14,000 genetic sequences of samples Neisseria gonorrhoeae This was collected by patients across the country between 2018 and 2024. The sequence data was created by the CDC gonorrhea monitoring system. The researchers were looking for a particular gene, called Tetm, which is known to help bacteria to avoid the effects of tetracycline.
This gene was found in less than 10% of genetic sequences collected in 2018, compared to over 30% of sequences collected in 2024. The most intense increase was in the northwestern Pacific. The researchers said many factors could be behind the increase in drug -resistant gonorrhea, but agreed that the Doxy Pep probably contributed to it.
A second study In the Northwest Pacific he confirmed this theory. Researchers at the University of Washington in Seattle examined antibiotic resistance to Neisseria gonorrhoeaeUsing monitoring data from King County as well as data from patients at the sexual health clinic in the area. The study included 2,312 men who had sex with men (MSM) who had tried positively for gonorrhea. Between 2017 and the beginning of 2023, about 27% of gonorrhea cases showed signs of tetracycline resistance. By mid -2024, however, 70% of gonorrhea cases showed this resistance signed.
The researchers then examined the use of Doxy Pep. They found that the use of Doxy PEP was not associated with the presence of gonorrhea resistant to gonorrhea, but taking three or more doses of Doxy Pep per month were. The researchers also examined the other bacteria in the patients’ throats (these were natural bacteria that did not cause infections). They found that Doxy Pep users were also more likely to have Staph antibiotic and Strep bacteria resistant to their throats than non -users.
More surveys are required
No one is a suggestion to abandon this new prevention strategy. Public Health experts continue to support the use of Doxy PEP for people with a higher change in STD exposure. But they say we have to watch it closely.
As Dr. Barbara van der Pol from the University of Alabama in Birmingham, he told ASHA: “It’s too early to suggest to stop taking the Doxy Pep.” He said the real path from this study is that “… Public Health Services must continue to receive funding/support for the critical work of monitoring infectious diseases”.
