Important considerations regarding the widespread use of doxycycline chemoprophylaxis against sexually transmitted infections

Rates of sexually transmitted infections (STIs) continue to rise across the world and interventions are essential to reduce their incidence. Past and recent studies have indicated this may be achieved using doxycycline post-exposure prophylaxis (PEP) and this has sparked considerable interest in its use. However, many unanswered questions remain as to its long-term effects and particularly potentially negative impact on human microbiomes and antimicrobial resistance among STIs, other pathogens, and commensals. In this review, we discuss seven areas of concern pertaining to the widespread use of doxycycline PEP.

Automated summary

Rates of STIs are increasing worldwide, and interventions using doxycycline post-exposure prophylaxis (PEP) have shown promise in reducing incidence. However, unanswered questions regarding long-term effects on microbiomes, antimicrobial resistance, and potential impact on STIs and other pathogens remain. In this review, seven areas of concern regarding the widespread use of doxycycline PEP are discussed.