{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:09:50Z","timestamp":1791468590109,"version":"4.3.4"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T00:00:00Z","timestamp":1740700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Public Health\u2014Seattle & King County for Strengthening the United States Response to Resistant Gonorrhea"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Doxycycline post-exposure prophylaxis (doxy PEP) is increasingly used among men who have sex with men (MSM). Its impact on antimicrobial resistance and the microbiome is uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used Neisseria gonorrhoeae (NG) surveillance data from King County, Washington, USA, and joinpoint regression to investigate trends in NG-tetracycline resistance (tetR), 2017\u20132024 and, among sexual health clinic (SHC) patients, evaluated the association of NG-tetR with doxy PEP use. We evaluated nasopharyngeal colonization with Staphylococcus aureus and Group A Streptococcus (GAS) in 703 MSM SHC patients, August 2023-July 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 2312 MSM with NG, tetR was stable 2017 to quarter 1 (Q1) 2023 (mean = 27%) and thereafter rose to 70% in Q2 2024 (P &amp;lt; .0001). (King County released doxy PEP guidelines in Q2 2023.) NG with high-level (HL) tetR increased Q1 2021 to Q2 2024 (2% to 65%) (P &amp;lt; .0001). Taking &amp;gt;3 doses of doxy PEP\/month was associated with both tetR and HL tetR (P \u2264 .01 for both), though any use of doxy PEP was not associated with tetR or HL tetR. S. aureus colonization was less common among doxy PEP users than non-users (27% vs 36%, P = .02), but colonization with both tetracycline-resistant S. aureus and GAS were more common among doxy PEP users than non-users (18% vs 8%, P &amp;lt; .0001% and 9% vs 4%, P = .008, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TetR in NG rapidly increased from 2021 to 2024, and most NG among King County MSM now have HL tetR. Doxy PEP use is associated with colonization with GAS and tetracycline-resistant S. aureus, suggesting that doxy PEP impacts off-target bacteria.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf089","type":"journal-article","created":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T07:50:01Z","timestamp":1740642601000},"page":"1188-1196","source":"Crossref","is-referenced-by-count":57,"title":["Potential Impact of Doxycycline Post-Exposure Prophylaxis on Tetracycline Resistance in\n                    <i>Neisseria gonorrhoeae<\/i>\n                    and Colonization With Tetracycline-Resistant\n                    <i>Staphylococcus aureus<\/i>\n                    and Group A\n                    <i>Streptococcus<\/i>"],"prefix":"10.1093","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8504-2319","authenticated-orcid":false,"given":"Olusegun O","family":"Soge","sequence":"first","affiliation":[{"name":"Department of Global Health, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Department of Laboratory Medicine and Pathology, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Center of AIDS and STD, University of Washington , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina S","family":"Thibault","sequence":"additional","affiliation":[{"name":"Public Health\u2014Seattle & King County, HIV\/STI\/HCV Program , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2962-754X","authenticated-orcid":false,"given":"Chase A","family":"Cannon","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Center of AIDS and STD, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Public Health\u2014Seattle & King County, HIV\/STI\/HCV Program , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6658-8260","authenticated-orcid":false,"given":"Stephanie E","family":"McLaughlin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Center of AIDS and STD, University of Washington , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim W","family":"Menza","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Center of AIDS and STD, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Public Health\u2014Seattle & King County, HIV\/STI\/HCV Program , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1907-9428","authenticated-orcid":false,"given":"Julia C","family":"Dombrowski","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Center of AIDS and STD, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Public Health\u2014Seattle & King County, HIV\/STI\/HCV Program , Seattle, Washington ,","place":["USA"]},{"name":"Department of Epidemiology, University of Washington , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3243-110X","authenticated-orcid":false,"given":"Ferric C","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Global Health, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Department of Laboratory Medicine and Pathology, University of Washington , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew R","family":"Golden","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Center of AIDS and STD, University of Washington , Seattle, Washington ,","place":["USA"]},{"name":"Public Health\u2014Seattle & King County, HIV\/STI\/HCV Program , Seattle, Washington ,","place":["USA"]},{"name":"Department of Epidemiology, University of Washington , Seattle, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,2,28]]},"reference":[{"key":"2025071809220265800_ciaf089-B1","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/S1473-3099(17)30725-9","article-title":"Post-exposure prophylaxis with doxycycline to prevent sexually transmitted infections in men who have sex with men: an open-label randomised substudy of the ANRS IPERGAY trial","volume":"18","author":"Molina","year":"2018","journal-title":"Lancet Infect Dis"},{"key":"2025071809220265800_ciaf089-B2","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1056\/NEJMoa2211934","article-title":"Postexposure doxycycline to prevent bacterial sexually transmitted infections","volume":"388","author":"Luetkemeyer","year":"2023","journal-title":"N Engl J Med"},{"key":"2025071809220265800_ciaf089-B3","author":"Molina"},{"key":"2025071809220265800_ciaf089-B4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr7302a1","article-title":"CDC clinical guidelines on the use of doxycycline postexposure prophylaxis for bacterial sexually transmitted infection prevention, United States, 2024","volume":"73","author":"Bachmann","year":"2024","journal-title":"MMWR Recomm Rep"},{"key":"2025071809220265800_ciaf089-B5","author":"Scott"},{"key":"2025071809220265800_ciaf089-B6","doi-asserted-by":"crossref","first-page":"1831","DOI":"10.1007\/s15010-023-02086-9","article-title":"Already current practice? A snapshot survey on doxycycline use for prevention of sexually transmitted infections in parts of the German MSM community","volume":"51","author":"Hornuss","year":"2023","journal-title":"Infection"},{"key":"2025071809220265800_ciaf089-B7","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1136\/sextrans-2024-056152","article-title":"Early adopters of doxycycline as post-exposure prophylaxis to prevent bacterial sexually transmitted infections in a real-world clinical setting","volume":"100","author":"Chan","year":"2024","journal-title":"Sex Transm Infect"},{"key":"2025071809220265800_ciaf089-B8","author":"Sankaran"},{"key":"2025071809220265800_ciaf089-B9","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1097\/OLQ.0000000000002079","article-title":"Acceptability of doxycycline prophylaxis, prior antibiotic use, and knowledge of antimicrobial resistance among Australian gay and bisexual men and nonbinary people","volume":"52","author":"Holt","year":"2024","journal-title":"Sex Transm Dis"},{"key":"2025071809220265800_ciaf089-B10","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1097\/OLQ.0000000000002061","article-title":"Use of doxycycline and other antibiotics as bacterial sexually transmitted infection prophylaxis in a US sample of primarily gay and bisexual men","volume":"51","author":"Traeger","year":"2024","journal-title":"Sex Transm Dis"},{"key":"2025071809220265800_ciaf089-B11","first-page":"217","article-title":"A survey of problems in the antibiotic treatment of gonorrhoea. With special reference to South-East Asia","volume":"46","author":"Willcox","year":"1970","journal-title":"Br J Vener Dis"},{"key":"2025071809220265800_ciaf089-B12","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1136\/sextrans-2021-054992","article-title":"Where to go to in Chlamydia control? From infection control towards infectious disease control","volume":"97","author":"van Bergen","year":"2021","journal-title":"Sex Transm Infect"},{"key":"2025071809220265800_ciaf089-B13","doi-asserted-by":"crossref","first-page":"100743","DOI":"10.1016\/j.lanepe.2023.100743","article-title":"Management of asymptomatic sexually transmitted infections in Europe: towards a differentiated, evidence-based approach","volume":"34","author":"Kenyon","year":"2023","journal-title":"Lancet Reg Health Eur"},{"key":"2025071809220265800_ciaf089-B14","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1093\/jac\/dkad129","article-title":"Important considerations regarding the widespread use of doxycycline chemoprophylaxis against sexually transmitted infections","volume":"78","author":"Kong","year":"2023","journal-title":"J Antimicrob Chemother"},{"key":"2025071809220265800_ciaf089-B15","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1038\/s41591-024-03274-2","article-title":"Impact of doxycycline post-exposure prophylaxis for sexually transmitted infections on the gut microbiome and antimicrobial resistome","volume":"31","author":"Chu","year":"2024","journal-title":"Nat Med"},{"key":"2025071809220265800_ciaf089-B16","author":"Luetkemeyer"},{"key":"2025071809220265800_ciaf089-B17","doi-asserted-by":"crossref","first-page":"381","DOI":"10.5694\/mja2.52258","article-title":"Australian consensus statement on doxycycline post-exposure prophylaxis (doxy-PEP) for the prevention of syphilis, chlamydia and gonorrhoea among gay, bisexual and other men who have sex with men","volume":"220","author":"Cornelisse","year":"2024","journal-title":"Med J Aust"},{"key":"2025071809220265800_ciaf089-B18","author":"Public Health Seattle and King County HIV\/STI\/HCV Program doxy PEP Guidelines"},{"issue":"12S","key":"2025071809220265800_ciaf089-B19","doi-asserted-by":"crossref","first-page":"S97","DOI":"10.1097\/OLQ.0000000000001545","article-title":"Strengthening the US Response to resistant gonorrhea: an overview of a multisite program to enhance local response capacity for antibiotic-resistant Neisseria gonorrhoeae","volume":"48","author":"Schlanger","year":"2021","journal-title":"Sex Transm Dis"},{"key":"2025071809220265800_ciaf089-B20","volume-title":"Performance standards for antimicrobial susceptibility testing","author":"Clinical and Laboratory Standards Institute","year":"2021","edition":"31st ed"},{"key":"2025071809220265800_ciaf089-B21","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1128\/AAC.30.5.664","article-title":"High-level tetracycline resistance in Neisseria gonorrhoeae is result of acquisition of streptococcal tetM determinant","volume":"30","author":"Morse","year":"1986","journal-title":"Antimicrob Agents Chemother"},{"key":"2025071809220265800_ciaf089-B22","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1093\/cid\/ciq146","article-title":"Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children","volume":"52","author":"Liu","year":"2011","journal-title":"Clin Infect Dis"},{"key":"2025071809220265800_ciaf089-B23","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1001\/archderm.139.4.467","article-title":"Effect of antibiotics on the oropharyngeal flora in patients with acne","volume":"139","author":"Levy","year":"2003","journal-title":"Arch Dermatol"},{"key":"2025071809220265800_ciaf089-B24","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1086\/520016","article-title":"Throat swabs are necessary to reliably detect carriers of Staphylococcus aureus","volume":"45","author":"Mertz","year":"2007","journal-title":"Clin Infect Dis"},{"key":"2025071809220265800_ciaf089-B25","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1128\/jcm.12.5.641-643.1980","article-title":"Rapid and reliable identification of Staphylococcus aureus by a latex agglutination test","volume":"12","author":"Essers","year":"1980","journal-title":"J Clin Microbiol"},{"key":"2025071809220265800_ciaf089-B26","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.mimet.2015.07.014","article-title":"Evaluation of the Biotyper MALDI-TOF MS system for identification of Staphylococcus species","volume":"117","author":"Zhu","year":"2015","journal-title":"J Microbiol Methods"},{"key":"2025071809220265800_ciaf089-B27","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1128\/jcm.15.6.987-990.1982","article-title":"Presumptive identification of streptococci with a new test system","volume":"15","author":"Facklam","year":"1982","journal-title":"J Clin Microbiol"},{"key":"2025071809220265800_ciaf089-B28","doi-asserted-by":"crossref","first-page":"4207","DOI":"10.1128\/JCM.40.11.4207-4210.2002","article-title":"Performance characteristics and utilization of rapid antigen test, DNA probe, and culture for detection of Group A streptococci in an acute care clinic","volume":"40","author":"Chapin","year":"2002","journal-title":"J Clin Microbiol"},{"key":"2025071809220265800_ciaf089-B29","doi-asserted-by":"crossref","first-page":"3004","DOI":"10.1128\/JCM.00240-11","article-title":"Evaluation of matrix-assisted laser desorption ionization-time of flight mass spectrometry for rapid identification of Beta-hemolytic streptococci","volume":"49","author":"Cherkaoui","year":"2011","journal-title":"J Clin Microbiol"},{"key":"2025071809220265800_ciaf089-B30","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1002\/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z","article-title":"Permutation tests for joinpoint regression with applications to cancer rates","volume":"19","author":"Kim","year":"2000","journal-title":"Stat Med"},{"key":"2025071809220265800_ciaf089-B31"},{"key":"2025071809220265800_ciaf089-B32","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1001\/archderm.141.9.1132","article-title":"Antibiotic treatment of acne may be associated with upper respiratory tract infections","volume":"141","author":"Margolis","year":"2005","journal-title":"Arch Dermatol"},{"key":"2025071809220265800_ciaf089-B33","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1001\/archdermatol.2011.355","article-title":"Association of pharyngitis with oral antibiotic use for the treatment of acne: a cross-sectional and prospective cohort study","volume":"148","author":"Margolis","year":"2012","journal-title":"Arch Dermatol"},{"key":"2025071809220265800_ciaf089-B34","doi-asserted-by":"crossref","first-page":"eabd8077","DOI":"10.1126\/scitranslmed.abd8077","article-title":"Alterations of human skin microbiome and expansion of antimicrobial resistance after systemic antibiotics","volume":"13","author":"Jo","year":"2021","journal-title":"Sci Transl Med"},{"key":"2025071809220265800_ciaf089-B35","doi-asserted-by":"crossref","first-page":"dlac009","DOI":"10.1093\/jacamr\/dlac009","article-title":"A systematic review of the impacts of oral tetracycline class antibiotics on antimicrobial resistance in normal human flora","volume":"4","author":"Truong","year":"2022","journal-title":"JAC Antimicrob Resist"},{"key":"2025071809220265800_ciaf089-B36","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1111\/1523-1747.ep12275004","article-title":"Long-term antibiotic therapy for acne vulgaris: effects on the bowel flora of patients and their relatives","volume":"85","author":"Adams","year":"1985","journal-title":"J Invest Dermatol"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciaf089\/62202134\/ciaf089.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/80\/6\/1188\/62202134\/ciaf089.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/80\/6\/1188\/62202134\/ciaf089.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T13:22:09Z","timestamp":1752844929000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/80\/6\/1188\/8045759"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,28]]},"references-count":36,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,2,28]]},"published-print":{"date-parts":[[2025,7,18]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciaf089","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,6,15]]},"published":{"date-parts":[[2025,2,28]]}}}