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• Posted October 2, 2023

CDC Will Recommend an Antibiotic After Sex to Help Prevent Sexually Transmitted Infections

The U.S. Centers for Disease Control and Prevention is poised to recommend use of a powerful antibiotic to prevent sexually transmitted infections.

On Monday, the CDC issued draft recommendations, recommending doctors consider prescribing doxycycline to help prevent the spread of disease.

Officials told CBS News the approach could mark a turning point in the nation's ongoing epidemic of sexually transmitted infections, or STIs.

Dubbed Doxy-PEP -- short for doxcycline post-exposure -- the approach calls for taking the antibiotic after a potential STI exposure rather waiting until after a disease is diagnosed.

"It's going to take game-changing innovations for us to turn the STI epidemic around. And Doxy-PEP is the first major new prevention intervention we have for STIs in decades," Dr. Jonathan Mermin, head of the CDC's National Center for HIV, Viral Hepatitis, STD, and TB Prevention, said in an interview with CBS News.

If the draft recommendation is adopted, Doxy-PEP would be recommended for gay and bisexual men; other men who have sex with men; and transgender women who have been diagnosed with at least one STI caused by bacteria in the past year. Those infections include gonorrhea, chlamydia or syphilis.

The CDC is expected to advise doctors that prescribing a 200 mg dose of doxycycline "should be considered" for these patients within 72 hours after oral, vaginal or anal sex.

The agency needs more data before recommending it for other groups.

The CDC isn't the first to back this strategy. Health departments in California, Michigan and New Mexico, among other agencies, already have guidance on Doxy-PEP.

David Harvey, executive director of the National Coalition of STD Directors, hailed the proposed recommendation.

"There is not a lot of money in STI care, prevention and research," Harvey told CBS News. "So this development is profound for our field. And the community has already been working hard to implement Doxy-PEP and clinicians in some public health clinics are prescribing this widely."

The CDC recommendations could help cover the cost of the pills through public health budgets and insurance, he said.

As part of the CDC draft recommendation, there is a request for doctors to assess side effects of Doxy-PEP and to screen every three to six months for breakthrough infections.

"Larger evaluations can sometimes show negative outcomes that have been missed in smaller randomized trials," Mermin told CBS News. "So we are going to be continuing to monitor and evaluate the implementation of Doxy-PEP over time."

Whether this idea will lead to antibiotic resistance is a concern. Experts speaking at a meeting of the National Association of County and City Health Officials last year warned about that issue.

The CDC plans to monitor for drug resistance, and to update guidelines as needed, Mermin said.

"There are important questions that remain regarding potential risks," he added.

The CDC is taking comments for 45 days on the recommendations through Nov. 16. A final version will likely be published early next year.

"We think this is the right step right now, even though science is still evolving," Mermin said.

More information

The World Health Organization has more on sexually transmitted infections.

SOURCES: U.S. Centers for Disease Control and Prevention, draft recommendation, Oct. 2, 2023; CBS News, Oct. 2, 2023