The following is a summary of “Doxycycline prophylaxis for the prevention of sexually transmitted infections: A systematic review and meta-analysis of randomized controlled trials,” published in the October 2024 issue of Infectious Disease by Szondy et al.
Researchers conducted a retrospective study to evaluate the efficacy of doxy- pre-exposure prophylaxis (PrEP)/ postexposure prophylaxis (PEP) in preventing bacterial sexually transmitted infections (STIs).
They searched PubMed, Embase, and CENTRAL for randomized controlled trials (RCTs), including ongoing studies up to November 7, 2023. The primary endpoint was bacterial STI incidence, calculated as number of visits with an STI per total visit. A random-effects model estimated pooled effect sizes. The study was registered with PROSPERO, CRD42023478486.
The results showed 6 eligible studies from 7 articles and 4 conference abstracts, enrolling men who have sex with men (MSM), transgender women (TGW), and cisgender women (CGW). A pooled analysis of 1,766 participants, including 602 newly diagnosed STIs, demonstrated a 56% reduction in overall STI incidence with doxy-PrEP/PEP (Risk Ratio [RR] = 0.44; 95% [CI]: 0.30-0.65; I2= 73%), for doxy-PEP in MSM and TGW, the RR for STI incidence was 0.40 (95% CI: 0.28-0.57; I2 = 37%), 0.19 (95% CI: 0.08-0.44; I2 = 39%) for chlamydia, 0.23 (95% CI: 0.14-0.36; I2 = 0%) for syphilis, and 0.55 (95% CI: 0.34-0.87; I2 = 41%) for gonorrhea with no serious adverse event, and the evidence certainty for doxy-PEP efficacy among MSM and TGW was graded high.
They concluded that doxy-PEP lowered the incidence of chlamydia and syphilis and was effective against gonorrhea, making it a promising tool for preventing bacterial STIs among MSM and TGW.
Source: sciencedirect.com/science/article/pii/S1201971224002571
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