Role of doxycycline post exposure prophylaxis in the prevention of sexually transmitted infections: a narrative review

Abstract

Sexually transmitted infections (STIs) spread through sexual intercourse. They are caused by pathogens like Neisseria gonorrhoeae, Treponema pallidum, Chlamydia trachomatis, and Mycoplasma genitalium, and can be transmitted through direct contact or contact with genital secretions. Doxycycline is a second-generation tetracycline antibiotic with a broad antimicrobial spectrum, acting on intracellular and extracellular organisms. This review aims to explore the efficacy of doxycycline post-exposure prophylaxis (PEP) in the prevention and treatment of STIs. Some of the areas of uncertainty with the use of doxycycline PEP for STIs include the concern for developing antimicrobial resistance (AMR), the effect on the normal microbiome of the body, public acceptability, drug formulation and dosage and compliance issues. Recent clinical and observational studies have looked at using doxycycline PEP to reduce the transmission of STIs. This review aims to explore these studies to provide a comprehensive account of the current state of doxycycline PEP and its future prospects. We also look at the limitations and areas of improvement in using doxycycline PEP, opening avenues for future research. High-quality studies have shown that using doxycycline PEP can effectively reduce the transmission of STIs in a number of clinical trials as well as systematic reviews., making it a potential standard treatment for high-risk groups such as immunocompromised patients, individuals living with HIV, sex workers, and men who have sex with men (MSM).