Doxycycline Post-exposure Prophylaxis and Sexually Transmitted Infections in Italy, 2023.

This article focuses on the implications of doxycycline post-exposure prophylaxis (doxyPEP) for sexually transmitted infections (STIs), particularly concerning antimicrobial resistance in Neisseria gonorrhoeae. Data from an STI clinic in Turin, Italy, revealed high tetracycline resistance (97.4%) among gonorrhea isolates, raising concerns that increased doxyPEP use may select for strains resistant to both tetracyclines and ceftriaxone. The authors also highlight limited alternative treatments for other STIs like Chlamydia trachomatis and Treponema pallidum, noting challenges in antimicrobial susceptibility testing. They caution that while doxyPEP is effective for preventing serious infections like malaria, its use for bacterial STIs—which are generally treatable—may not be justified due to potential resistance development and suggest that regular screening and prompt treatment could be preferable.