1. Doxycycline prophylaxis for the prevention of sexually transmitted infections: A systematic review and meta-analysis of randomized controlled trials.
- Author
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Szondy I, Meznerics FA, Lőrincz K, Kemény LV, Walter A, Mohammed AA, Hegyi P, Kiss N, and Bánvölgyi A
- Subjects
- Humans, Male, Female, Gonorrhea prevention & control, Gonorrhea epidemiology, Sexually Transmitted Diseases prevention & control, Sexually Transmitted Diseases epidemiology, Homosexuality, Male, Sexually Transmitted Diseases, Bacterial prevention & control, Sexually Transmitted Diseases, Bacterial epidemiology, Sexually Transmitted Diseases, Bacterial microbiology, Incidence, Post-Exposure Prophylaxis methods, Pre-Exposure Prophylaxis methods, Chlamydia Infections prevention & control, Chlamydia Infections epidemiology, Syphilis prevention & control, Syphilis epidemiology, Transgender Persons, Doxycycline therapeutic use, Randomized Controlled Trials as Topic, Anti-Bacterial Agents therapeutic use
- Abstract
Objectives: To investigate the effects of doxycycline pre- and post-exposure prophylaxis (doxy-PrEP/PEP) on bacterial sexually transmitted infections (STIs) by conducting a systematic review and meta-analysis., Methods: PubMed, Embase, and CENTRAL were searched for randomized controlled trials (RCTs), including ongoing studies published until November 7, 2023. Our primary endpoint was the incidence of bacterial STIs measured as the number of visits with an STI per total number of visits. Random-effects model was used to estimate pooled effect sizes. The study was registered with PROSPERO, CRD42023478486., Results: We identified six eligible studies containing data from seven articles and four conference abstracts, enrolling men who have sex with men (MSM), transgender women (TGW), and cisgender women (CGW). The pooled analysis of 1,766 participants with 602 newly diagnosed STIs showed a 56% decrease in the overall STI incidence using doxy-PrEP/PEP (RR = 0.44; 95% CI: 0.30-0.65; I
2 = 73%). For doxy-PEP, including MSM and TGW only, the RR observed for overall 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 (0.14-0.36; I² = 0%) for syphilis and 0.55 (95% CI: 0.34-0.87; I² = 41%) for gonorrhea. No serious adverse events were reported in the studies. The certainty of evidence regarding the efficacy of doxy-PEP among MSM and TGW was graded as high., Conclusion: Doxy-PEP significantly reduces the number of new cases of chlamydia and syphilis and is potentially effective against gonorrhea, influenced by local resistance patterns. Thus, it is a promising tool in the prevention of bacterial STIs among MSM and TGW., Competing Interests: Declarations of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)- Published
- 2024
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