medicine can be about to achieve a long-sought goal: a “morning-after pill” to prevent sexually transmitted infections. It could drastically reduce rising disease rates and huge health care costs.
The effectiveness of this pill, and it is literally a pill, a 200-milligram tablet of the antibiotic doxycycline, has been studied for a decade and people have taken it covertly for years. But the results of the study published in The New England Journal of Medicine it seems likely that it will tip the pill towards clinical practice. In the study, conducted in San Francisco and Seattle, participants who took a single dose within 72 hours of having sex without a condom were only one-third as likely to contract chlamydia, gonorrhea or syphilis than those who did not take the pills. .
As with everything in medicine, there are footnotes of the findings and risks to balance the benefits. The study was conducted only among gay and bisexual men, along with transgender women and non-binary people assigned as male at birth. Within those groups, it was limited to people who had been diagnosed with a sexually transmitted infection (STI) in the past year. The study did not include cisgender women; in previous studies, the preventative antibiotic has not worked as well for them. And the study noted, but did not fully explore, the possibility that routine administration of an antibiotic could provoke resistance either among the bacteria that cause STIs or others found in the body of the participants.
All that said, the results have created a lot of excitement among doctors and people who would be eligible to take what’s called doxyPEP (doxycycline post-exposure prophylaxis), despite health authorities such as the Centers for for Disease Control and Prevention has not yet made formal recommendations for its use.
“I think this is a real game changer,” says Paul Adamson, an infectious disease physician and assistant clinical professor of medicine at the University of California, Los Angeles. “We have a large number of bacterial STIs in the US Gay and bisexual men who have sex with men bear a disproportionate burden from them. And we haven’t had a lot of tools that we can use to help.”
To understand why doxyPEP could be so significant, it’s important to consider what has been happening with STIs. Briefly: they are shooting. Since 2017, According to the Centers for Disease Control and Prevention, the most important of these diseases has reached historical highs: gonorrhea has increased by 28 percent and syphilis by 74 percent. And while chlamydia diagnoses have not returned to pre-COVID-19 levels, the agency is concerned that this may be due to disruptions in care from the pandemic, rather than an actual decline in transmission. All of these infections have profound long-term consequences if they are not diagnosed and treated, including making people more vulnerable to HIV infection. Collectively, they cost the US health care system. more than $1 billion by year.
Meanwhile, congenital syphilis – which is transmitted from mother to child at birth, a sign that the pregnant woman never received adequate prenatal care – caused 220 stillbirths and infant deaths in 2021, the last year for which there are national figures. gonorrhea is winning resistance to the latest antibiotics currently available for treatment.