Health
Use of antibiotics to prevent STI found to be effective in early science fiction studies
UCSF researchers studying the use of antibiotics to prevent sexually transmitted diseases in high-risk individuals find it unethical that the initial results are that the intervention is effective and does not provide it more widely. This month, we suddenly stopped enrolling new participants in clinical trials after showing that.
The full findings will not be presented until this summer at the International AIDS Conference in Canada. There are also questions about the safety of antibiotics in the long run, such as whether regular use of antibiotics as a prophylaxis leads to more drugs. Resistant bacteria, researchers said.
However, for some people, they find that taking antibiotics immediately after participating in a particular sexual activity (a practice known as DoxyPEP for post-exposure prophylaxis) can prevent sexually transmitted infections. I was prompted to.
“The study ended early because of its effectiveness. Great news,” said Dr. Annie Luetkemeyer, an infectious disease expert at the University of California, San Francisco, who led the trial in San Francisco.
Incidence of sexually transmitted diseases, especially gonorrhea, chlamydia and syphilis, has risen steadily in the United States over the past decade, although Significant decline in the first year of the pandemicProbably due to lack of testing and people with less intimate contact due to repeated lockdowns.
To curb the trend, advocates of sexual health are looking for new strategies to help people prevent bacterial infections. Condoms are an option, but not many people use condoms consistently, Luetkemeyer said.
European researchers began studying the use of antibiotics as a prophylaxis about five years ago, following the PrEP model, or anti-virus pre-exposure prophylaxis to prevent HIV infection. The UCSF trial, conducted in collaboration with the University of Washington, is the first trial to study this approach in the United States.
The DoxyPEP trial is underway and nearly 650 participants are enrolled in two clinics in San Francisco and two in Seattle. All participants are men who have had sex with a man or transgender woman who had at least one sexually transmitted disease the previous year and are living with HIV or using PrEP.
Participants were enrolled in one of two research groups. One has access to prophylactic antibiotics and the other is a control group. The antibiotic group was given doxycycline, a common antibiotic for treating sexually transmitted diseases, for 3 months, and 200 mg tablets within 3 days of oral, anal, or vaginal sexual intercourse without a condom. I was instructed to take 1 tablet. They were able to replenish as many prescriptions as needed.
Lutokumayer said the specific consequences of the trial could not yet be revealed. However, the Safety Ethics Board, assigned to monitor the results on a regular basis, is concerned about continuing to classify participants into control groups, as antibiotics are so effective in preventing infection. I discovered that this month.
Researchers stopped participating in the trial earlier this month and are now offering DoxyPEP to all participants in the control group, Luetkemeyer said. Participants will continue to be monitored for 12 months.
Taking antibiotics to prevent infection is not without potential risks, both in terms of the development of drug-resistant pathogens and the disruption of the individual’s microbiota, a complex system of bacteria that occupy the intestine. , Said Luetkemeyer. In the last decade, gonorrhea may already be difficult to treat due to drug resistance. Infectious disease specialists have already identified some cases of gonorrhea worldwide that are resistant to all antibiotics.
According to Lutokumayer, the first study of DoxyPEP may not be able to determine whether the use of antibiotics for prevention develops drug resistance, requiring more testing. Still, she and other health care providers say they are encouraged by what they have seen so far.
“HIVPrEP demonstrates the power of biomedical prevention in the field of sexually transmitted diseases and certainly enhances the enthusiasm for identifying other STI biomedical prevention solutions,” said San Francisco City Clinic. Dr. Stephanie Cohen, Medical Director of the Department of Medicine, said. DoxyPEP trial site.
She said there are significant differences between DoxyPEP and HIV PrEP, which can affect whether people are interested in prevention. Like drug resistance. However, City Clinic clients are already interested in DoxyPEP, and Cohen believes that some people will benefit from taking advantage of this option.
“Some community members have decided,’I’m really tired of feeling sexually transmitted diseases and discomfort, and I have to talk to my partner,'” Cohen said. “I think this strategy has a lot of enthusiasm among some communities.”
Erin Allday is a staff writer for the San Francisco Chronicle. Email: [email protected] twitter: @erinallday
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