US recommends taking antibiotics after sex to prevent disease

Amid rising sexually transmitted infections (STIs), US health officials on October 2 proposed that doctors prescribe a common antibiotic to be taken after sex, despite concerns about the possibility of creating more drug-resistant strains of bacteria.

DoxyPEP, or doxycycline, was used as post-exposure prophylaxis and reduced the risk of these infections in clinical trials in men who have sex with men and transgender women without using condoms.

Draft guidance from the US Centers for Disease Control and Prevention (CDC) targets high-risk groups, amid concerns that broader recommendations could fuel the rise of drug-resistant superbugs.

“Innovation and creativity are critical to public health, and more tools are needed,” said Jonathan Mermin, chief of STI prevention at the CDC.

Guidelines recommend a single 200 mg dose taken orally within 72 hours of unprotected sex.

The number of reported cases of the three bacterial infections rose to 2.5 million in the US in 2021, after rising for a decade. Some of the reason is thought to be that fewer people are using condoms since the introduction of PrEP, a daily pill that significantly reduces the risk of HIV infection.

Another potential reason for the increase is that PrEP users are recommended to get health checks every three months, potentially increasing the likelihood of identifying infections. There is also the basic epidemiological fact that the more people infected, the more likely they are to spread the infection.

Expanded access to doxycycline has led to concerns about antibiotic resistance, particularly in rapidly evolving gonorrhea. However, initial research has not found cause for alarm.