CDC Proposes Use of Doxycycline to Prevent Sexually Transmitted Infections in Certain Groups
In an effort to combat the rising rates of sexually transmitted infections (STIs) in the United States, the Centers for Disease Control and Prevention (CDC) has proposed the use of doxycycline as a preventive measure for chlamydia, gonorrhea, and syphilis infections. The draft recommendation, posted online on Monday, applies specifically to men who have sex with men and transgender women.
The CDC’s proposed guidelines, known as doxyPEP, suggest that healthcare providers consider prescribing a single 200mg dose of doxycycline within 72 hours after unprotected sex. This method, called post-exposure prophylaxis, has been found to be about 65% effective in reducing the incidence of these STIs.
Dr. Jonathan Mermin, director of CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention, emphasized the importance of public input in finalizing the guidelines. The CDC is currently seeking comments from interested individuals and organizations until November 16.
Until the CDC issues official guidance on the use of doxycycline, it remains available as an off-label prescription for STI prevention. The US Food and Drug Administration has not yet approved the medication for this specific use.
The proposal comes as the rate of sexually transmitted infections continues to rise across the country. In 2021 alone, more than 2.5 million STI cases were reported, representing a 7% increase from the previous year. Syphilis cases, in particular, are at their highest level in over 50 years.
The effectiveness of doxyPEP was demonstrated in a study published in the New England Journal of Medicine. The study involved 500 men who have sex with men and transgender women with a history of STIs. Participants were randomly assigned to receive either doxyPEP or standard care without doxyPEP. The study found that the combined incidence of gonorrhea, chlamydia, and syphilis was two-thirds lower among those who took doxyPEP within 72 hours of unprotected sex.
While some local health departments already have their own recommendations for the use of doxyPEP, the CDC’s proposed guidelines aim to provide updated clinical guidance for healthcare providers. The final guidelines are expected to be issued at a later date following the public comment period.
As STI rates continue to climb, it is crucial to explore new tools and preventive measures in order to curb the spread of these infections. The use of doxycycline as a preventive treatment shows promise in reducing the incidence of STIs, especially among high-risk populations.