Doxycycline Post-Exposure Prophylaxis for Bacterial Sexually Transmitted Infections: The Current Landscape and Future Directions.

IF 3.7 2区医学 Q2 INFECTIOUS DISEASES

Current HIV/AIDS Reports Pub Date : 2024-10-30 DOI:10.1007/s11904-024-00709-w

Lao-Tzu Allan-Blitz, Kenneth H Mayer

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Abstract

Purpose of review: The incidence of bacterial sexually transmitted infections (STI) continues to rise particularly among men who have sex with men (MSM). Doxycycline post-exposure prophylaxis (doxy-PEP) has emerged as a promising biomedical prevention strategy. This review aims to summarize the results of recent studies, highlight the current normative guidance on the use of doxy-PEP, and discuss remaining questions.

Recent findings: In the past decade, there have been four randomized controlled trials and three real-world analyses of doxy-PEP, which consistently demonstrated a reduction in Chlamydia trachomatis and Treponema pallidum infections among MSM. Questions remain regarding the efficacy of doxy-PEP for Neisseria gonorrhoeae infection and among cisgender women. Possible detrimental impacts include an increase in antimicrobial resistance as well as alterations to the gut microbiome Doxy-PEP is an effective strategy for preventing Chlamydia trachomatis and Treponema pallidum among MSM. Further work is needed to investigate the benefits among other populations, as well as to monitor for adverse effects.

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针对细菌性性传播感染的强力霉素暴露后预防疗法：当前形势与未来方向》。

审查目的：细菌性性传播感染（STI）的发病率持续上升，尤其是在男男性行为者（MSM）中。多西环素暴露后预防疗法（doxy-PEP）已成为一种很有前景的生物医学预防策略。本综述旨在总结近期的研究结果，强调目前关于使用强力霉素后预防疗法的规范指南，并讨论尚存在的问题：在过去十年中，对强力杀菌剂进行了四项随机对照试验和三项真实世界分析，结果一致表明强力杀菌剂可减少男男性行为者中沙眼衣原体和苍白螺旋体的感染。对于淋病奈瑟菌感染和顺性别女性，强力杀菌EP 的疗效仍存在疑问。可能产生的不利影响包括抗菌药耐药性的增加以及肠道微生物组的改变强力杀菌EP 是预防 MSM 感染沙眼衣原体和苍白螺旋体的有效策略。还需要进一步开展工作，研究该药物在其他人群中的益处，并监测其不良影响。

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来源期刊

Current HIV/AIDS Reports INFECTIOUS DISEASES-

CiteScore

8.10

自引率

2.20%

发文量

期刊介绍： This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of HIV/AIDS. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antiretroviral therapies, behavioral aspects of management, and metabolic complications and comorbidity. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.