Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Sexual medicine

Doxycycline-PEP — novel and promising but needs monitoring

Nature Reviews Urology volume 20, pages 522–523 (2023)Cite this article

Subjects

Sexually transmitted infections (STIs) remain public health concerns. Doxycycline post-exposure prophylaxis to prevent STIs is a novel promising intervention, which in a new study caused an ∼65% reduction in incident STIs. However, long-term effects on STI prevalence, microbiomes and antimicrobial resistance among STI pathogens, non-STI pathogens and commensals need to be monitored.

Refers to Luetkemeyer, A. F. et al. Postexposure doxycycline to prevent bacterial sexually transmitted infections. N. Engl. J. Med. 388, 1296–1306 (2023).

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

References

  1. World Health Organization. Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021. Accountability for the global health sector strategies 2016–2021: actions for impact (WHO, 2021).

  2. Bavinton, B. R. & Grulich, A. E. HIV pre-exposure prophylaxis: scaling up for impact now and in the future. Lancet Public Health 6, E528–E533 (2021).

    Article  PubMed  Google Scholar 

  3. Molina, J.-M. et al. Post-exposure prophylaxis with doxycycline to prevent sexually transmitted infections in men who have sex with men: an open-label randomised substudy of the ANRS IPERGAY trial. Lancet Infect. Dis. 18, 308–317 (2018).

    Article  CAS  PubMed  Google Scholar 

  4. Luetkemeyer, A. F. et al. Postexposure doxycycline to prevent bacterial sexually transmitted infections. N. Engl. J. Med. 388, 1296–1306 (2023).

    Article  CAS  PubMed  Google Scholar 

  5. Fiore, M. A., Raisman, J. C., Wong, N. H., Hudson, A. O. & Wadsworth, C. B. Exploration of the Neisseria resistome reveals resistance mechanisms in commensals that may be acquired by N. gonorrhoeae through horizontal gene transfer. Antibiotics 9, 656 (2020).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Kong, F. Y. S., Kenyon, C. & Unemo, M. Important considerations regarding the widespread use of doxycycline chemoprophylaxis against sexually transmitted infections. J. Antimicrob. Chemother. https://doi.org/10.1093/jac/dkad129 (2023).

    Article  PubMed  Google Scholar 

  7. Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet 399, 629–655 (2022).

    Article  Google Scholar 

  8. Vanbaelen, T., Manoharan-Basil, S. S. & Kenyon, C. Doxycycline post exposure prophylaxis could induce cross-resistance to other classes of antimicrobials in Neisseria gonorrhoeae: an in-silico analysis. Sex. Transm. Dis. https://doi.org/10.1097/OLQ.0000000000001810 (2023).

    Article  PubMed  Google Scholar 

  9. Traeger, M. et al. Potential impact and efficiency of doxy-PEP among people with or at risk of HIV. Presented at the 30th Conference on Retroviruses and Opportunistic Infections (CROI) (2023).

  10. Mortimer, T. D. & Grad, Y. H. A genomic perspective on the near-term impact of doxycycline post-exposure prophylaxis on Neisseria gonorrhoeae antimicrobial resistance. Clin. Infect. Dis. https://doi.org/10.1093/cid/ciad279 (2023).

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Work at the WHO Collaborating Centre for Gonorrhoea and Other STIs is supported by grants to M.U. from, for example, the Örebro County Council Research Committee; the Foundation for Medical Research at Örebro University Hospital, Örebro, Sweden; the Global Antibiotic Research and Development Partnership (GARDP); the European Centre for Disease Prevention and Control; and WHO. F.Y.S.K. is supported by a University of Melbourne Faculty C.R. Roper Fellowship.

Author information

Authors and Affiliations

  1. WHO Collaborating Centre for Gonorrhoea and Other STIs, National Reference Laboratory for STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden

    Magnus Unemo

  2. Institute for Global Health, University College London, London, UK

    Magnus Unemo

  3. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia

    Fabian Yuh Shiong Kong

Authors
  1. Magnus Unemo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fabian Yuh Shiong Kong
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Magnus Unemo.

Ethics declarations

Competing interests

The authors declare no competing interests.

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Unemo, M., Kong, F.Y.S. Doxycycline-PEP — novel and promising but needs monitoring. Nat Rev Urol 20, 522–523 (2023). https://doi.org/10.1038/s41585-023-00788-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41585-023-00788-1

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing