Rising Antibiotic Use Among High-Risk Populations

New findings reveal a startling trend: 15% of respondents in an online survey reported using doxycycline for post- and pre-exposure prophylaxis (doxyPEP/PrEP) to prevent sexually transmitted infections (STIs). This study, published in Eurosurveillance, primarily surveyed men who have sex with men (MSM), as well as transgender and gender-diverse individuals in the Netherlands.

Informed and Uninformed Choices

The study uncovers that a staggering 65% of participants are considering using doxyPEP/PrEP in the future, even though it remains unendorsed by healthcare professionals in the country. This informal use raises significant concerns about potential antimicrobial resistance (AMR) and risks altering the microbiome.

Effectiveness in STI Prevention vs. Public Health Risks

Research shows that doxyPEP can significantly reduce STIs such as syphilis and chlamydia, leading to debates about its broader public health implications. On one hand, providing doxyPEP to at-risk individuals could lead to fewer STIs and less antibiotic use; on the other hand, there are fears of increased overall antibiotic consumption and AMR.

Who is Using DoxyPEP?

The survey drew responses from 1,633 participants, recruited via various platforms, including dating apps and social media. 23% reported having used doxyPEP, with 15% confirming recent use. Notably, those who utilized doxyPEP were more likely to live with HIV or frequently engage in oral HIV PrEP.

Is Demand Growing?

With 65% planning to use doxyPEP/PrEP, and over two-thirds ready to finance it if available, the interest is evident. Interestingly, many participants obtained doxycycline through foreign sources or prescriptions, averaging €30 per medicine.

Risks of Untamed Usage

The study further emphasizes concerns regarding AMR and the long-term effects of doxyPEP/PrEP on gut health. Notably, without comprehensive awareness and monitoring of this informal usage, public health authorities struggle to address the risks of overuse and microbial imbalance.

Conclusion: A Double-Edged Sword?

In light of these findings, experts urge a balanced approach: while doxyPEP could significantly curb STIs among high-risk groups, its unchecked use poses critical public health challenges. Ongoing research and stringent monitoring will be vital to ensure that benefits do not come at the cost of rising antibiotic resistance.