{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T02:49:44Z","timestamp":1790909384789,"version":"4.1.0"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2019,9,1]],"date-time":"2019-09-01T00:00:00Z","timestamp":1567296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Team Klausner Saving Lives, UCLA Center for AIDS Research","award":["5P30 AI028697"],"award-info":[{"award-number":["5P30 AI028697"]}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["1R01AI139265"],"award-info":[{"award-number":["1R01AI139265"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Bacterial sexually transmitted infections (STIs) have been increasing over the past 2 decades in gay, bisexual, and other men who have sex with men. With the widespread use of early human immunodeficiency virus (HIV) treatment, which virtually eliminates transmission risk, and the availability of HIV pre-exposure prophylaxis, there have been attitudinal changes regarding HIV infection with resultant increases in sexual contact and declines in condom use. Doxycycline is used for primary prophylaxis in a number of infectious diseases. We conducted a state-of-the-art review to examine the current state of research, knowledge gaps, and challenges around the use of doxycycline prophylaxis to prevent syphilis and other STIs. International academic and government experts met in March 2019 to frame the initial inquiry, which was supplemented by focused literature searches. Two small short-term randomized controlled trials examining doxycycline prophylaxis found high efficacy. Five additional clinical studies are underway or in development. Studies differed in design, population, outcomes, and safety measures. Doxycycline prophylaxis for bacterial STIs shows promise. Better and more robust data are needed on efficacy; target population; community acceptability; behavioral risk compensation; doxycycline dose, regimen, and formulation; long-term safety; antimicrobial resistance; cost-effectiveness; and risk\u2013benefit.<\/jats:p>","DOI":"10.1093\/cid\/ciz866","type":"journal-article","created":{"date-parts":[[2019,8,29]],"date-time":"2019-08-29T15:27:49Z","timestamp":1567092469000},"page":"1247-1253","source":"Crossref","is-referenced-by-count":123,"title":["Doxycycline Prophylaxis for Bacterial Sexually Transmitted Infections"],"prefix":"10.1093","volume":"70","author":[{"given":"Juliana S","family":"Grant","sequence":"first","affiliation":[{"name":"JSG Health, LLC, Seattle, Washington DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chrysovalantis","family":"Stafylis","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, University of California\u2013Los Angeles (UCLA) David Geffen School of Medicine, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Connie","family":"Celum","sequence":"first","affiliation":[{"name":"Department of Global Health, University of Washington, Seattle, Washington DC, USA"},{"name":"Department of Medicine, University of Washington, Seattle, Washington DC, USA"},{"name":"Department of Epidemiology, University of Washington, Seattle, Washington DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Troy","family":"Grennan","sequence":"first","affiliation":[{"name":"British Columbia Centre for Disease Control and Division of Infectious Diseases, University of British Columbia, Vancouver, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridget","family":"Haire","sequence":"first","affiliation":[{"name":"The Kirby Institute, University of New South Wales, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kaldor","sequence":"first","affiliation":[{"name":"The Kirby Institute, University of New South Wales, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne F","family":"Luetkemeyer","sequence":"first","affiliation":[{"name":"Zuckerberg San Francisco General, University of California, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M","family":"Saunders","sequence":"first","affiliation":[{"name":"Blood Safety, Hepatitis, STI, and HIV Division, National Infection Service, Public Health England, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Michel","family":"Molina","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, St-Louis Hospital, University of Paris Diderot, Paris, France"},{"name":"INSERM U944, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey D","family":"Klausner","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, University of California\u2013Los Angeles (UCLA) David Geffen School of Medicine, Los Angeles, California, USA"},{"name":"Department of Epidemiology, University of California\u2013Los Angeles (UCLA), Los Angeles, California, USA"},{"name":"Fielding School of Public Health, University of California\u2013Los Angeles (UCLA), Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,9,1]]},"reference":[{"key":"2020070910542302500_CIT0001","volume-title":"sexually transmitted disease surveillance 2017","author":"Centers for Disease Control and Prevention","year":"2018"},{"key":"2020070910542302500_CIT0002","doi-asserted-by":"crossref","first-page":"43","DOI":"10.14745\/ccdr.v44i02a02","article-title":"Infectious and congenital syphilis in Canada, 2010\u20132015","volume":"44","author":"Choudhri","year":"2018","journal-title":"Can Commun Dis Rep"},{"key":"2020070910542302500_CIT0003","author":"European Centre for Disease Prevention and Control"},{"key":"2020070910542302500_CIT0004","volume-title":"HIV, viral hepatitis and sexually transmissible infections in Australia: annual surveillance report 2018","author":"Kirby Insitute","year":"2018"},{"key":"2020070910542302500_CIT0005","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1097\/QAD.0000000000001718","article-title":"Incidence of sexually transmitted infections before and after preexposure prophylaxis for HIV","volume":"32","author":"Nguyen","year":"2018","journal-title":"AIDS"},{"key":"2020070910542302500_CIT0006","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1007\/s10461-018-2252-9","article-title":"Changes in sexual behavior and STI diagnoses among MSM initiating PrEP in a clinic setting","volume":"23","author":"Monta\u00f1o","year":"2019","journal-title":"AIDS Behav"},{"key":"2020070910542302500_CIT0007","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.1001\/jama.2019.2947","article-title":"Association of HIV preexposure prophylaxis with incidence of sexually transmitted infections among individuals at high risk of HIV infection","volume":"321","author":"Traeger","year":"2019","journal-title":"JAMA"},{"key":"2020070910542302500_CIT0008","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1093\/cid\/ciy182","article-title":"Effects of pre-exposure prophylaxis for the prevention of human immunodeficiency virus infection on sexual risk behavior in men who have sex with men: a systematic review and meta-analysis","volume":"67","author":"Traeger","year":"2018","journal-title":"Clin Infect Dis"},{"key":"2020070910542302500_CIT0009","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.jclinepi.2016.01.032","article-title":"GRADE guidelines: 16. GRADE evidence to decision frameworks for tests in clinical practice and public health","volume":"76","author":"Sch\u00fcnemann","year":"2016","journal-title":"J Clin Epidemiol"},{"key":"2020070910542302500_CIT0010","first-page":"553","article-title":"Doxycycline in the management of sexually transmitted infections","volume":"73","author":"Peyriere","year":"2018","journal-title":"J Antimicrob Chemother"},{"key":"2020070910542302500_CIT0011","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1093\/infdis\/146.6.811","article-title":"Doxycycline propylaxis for human scrub typhus","volume":"146","author":"Twartz","year":"1982","journal-title":"J Infect Dis"},{"key":"2020070910542302500_CIT0012","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1056\/NEJM198402233100805","article-title":"An efficacy trial of doxycycline chemoprophylaxis against leptospirosis","volume":"310","author":"Takafuji","year":"1984","journal-title":"N Engl J Med"},{"key":"2020070910542302500_CIT0013","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1186\/s12936-015-0980-0","article-title":"Tetracyclines in malaria","volume":"14","author":"Gaillard","year":"2015","journal-title":"Malar J"},{"key":"2020070910542302500_CIT0014","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1056\/NEJM200107123450201","article-title":"Prophylaxis with single-dose doxycycline for the prevention of Lyme disease after an Ixodes scapularis tick bite","volume":"345","author":"Nadelman","year":"2001","journal-title":"N Engl J Med"},{"key":"2020070910542302500_CIT0015","first-page":"1","article-title":"Sexually transmitted diseases treatment guidelines, 2015","volume":"64","author":"Workowski","year":"2015","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2020070910542302500_CIT0016","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1097\/OLQ.0000000000000216","article-title":"Doxycycline prophylaxis to reduce incident syphilis among HIV-infected men who have sex with men who continue to engage in high-risk sex: a randomized, controlled pilot study","volume":"42","author":"Bolan","year":"2015","journal-title":"Sex Transm Dis"},{"key":"2020070910542302500_CIT0017","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":"2020070910542302500_CIT0018","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1097\/OLQ.0b013e31820e64fd","article-title":"Chemoprophylaxis is likely to be acceptable and could mitigate syphilis epidemics among populations of gay men","volume":"38","author":"Wilson","year":"2011","journal-title":"Sex Transm Dis"},{"key":"2020070910542302500_CIT0019","article-title":"Incidence of HIV-infection in the ANRS Prevenir study in Paris region with daily or on-demand PrEP with TDF\/FTC.","author":"Molina","year":"2018"},{"key":"2020070910542302500_CIT0020","first-page":"426338","article-title":"FLASH: a next-generation CRISPR diagnostic for multiplexed detection of antimicrobial resistance sequences","author":"Quan","year":"2018","journal-title":"bioRxiv"},{"key":"2020070910542302500_CIT0021","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1128\/AAC.32.1.68","article-title":"In vitro culture system to determine MICs and MBCs of antimicrobial agents against Treponema pallidum subsp. pallidum (Nichols strain)","volume":"32","author":"Norris","year":"1988","journal-title":"Antimicrob Agents Chemother"},{"key":"2020070910542302500_CIT0022","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1097\/OLQ.0000000000000235","article-title":"Preexposure prophylaxis to prevent bacterial sexually transmitted infections in men who have sex with men","volume":"42","author":"Golden","year":"2015","journal-title":"Sex Transm Dis"},{"key":"2020070910542302500_CIT0023","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1097\/00007435-200007000-00008","article-title":"Sexually transmitted disease clinic clients at risk for subsequent gonorrhea and chlamydia infections: possible \u201ccore\u201d transmitters","volume":"27","author":"Gunn","year":"2000","journal-title":"Sex Transm Dis"},{"key":"2020070910542302500_CIT0024","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1086\/516491","article-title":"An investigation of geographic clustering of repeat cases of gonorrhea and chlamydial infection in San Francisco, 1989\u20131993: evidence for core groups","volume":"175","author":"Ellen","year":"1997","journal-title":"J Infect Dis"},{"key":"2020070910542302500_CIT0025","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1517\/14740338.7.5.571","article-title":"The use and safety of doxycycline hyclate and other second-generation tetracyclines","volume":"7","author":"Sloan","year":"2008","journal-title":"Expert Opin Drug Saf"},{"key":"2020070910542302500_CIT0026","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1067\/mva.2001.117891","article-title":"Use of doxycycline to decrease the growth rate of abdominal aortic aneurysms: a randomized, double-blind, placebo-controlled pilot study","volume":"34","author":"Mosorin","year":"2001","journal-title":"J Vasc Surg"},{"key":"2020070910542302500_CIT0027","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1016\/j.jvs.2008.03.064","article-title":"A randomized, placebo-controlled trial of doxycycline after endoluminal aneurysm repair","volume":"48","author":"Hackmann","year":"2008","journal-title":"J Vascu Surg"},{"key":"2020070910542302500_CIT0028","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1067\/mva.2002.125018","article-title":"Prolonged administration of doxycycline in patients with small asymptomatic abdominal aortic aneurysms: report of a prospective (phase II) multicenter study","volume":"36","author":"Baxter","year":"2002","journal-title":"J Vasc Surg"},{"key":"2020070910542302500_CIT0029","doi-asserted-by":"crossref","first-page":"815","DOI":"10.7326\/0003-4819-159-12-201312170-00007","article-title":"Doxycycline for stabilization of abdominal aortic aneurysms: a randomized trial","volume":"159","author":"Meijer","year":"2013","journal-title":"Ann Intern Med"},{"key":"2020070910542302500_CIT0030","doi-asserted-by":"crossref","first-page":"517","DOI":"10.4269\/ajtmh.2011.10-0285","article-title":"Doxycycline for malaria chemoprophylaxis and treatment: report from the CDC expert meeting on malaria chemoprophylaxis","volume":"84","author":"Tan","year":"2011","journal-title":"Am J Trop Med Hyg"},{"key":"2020070910542302500_CIT0031","volume-title":"Position statement on doxycycline as post-exposure prophylaxis for sexually transmitted infections","author":"Public Health England, British Association for Sexual Health and HIV","year":"2017"},{"key":"2020070910542302500_CIT0032","volume-title":"Surveillance of antimicrobial resistance in Neisseria gonorrhoeae in England and Wales: key findings from the Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP)","author":"Public Health England","year":"2018"},{"key":"2020070910542302500_CIT0033","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1093\/jac\/dkx454","article-title":"Phenotypic antimicrobial susceptibility testing of Chlamydia trachomatis isolates from patients with persistent or successfully treated infections","volume":"73","author":"Pitt","year":"2018","journal-title":"J Antimicrob Chemother"},{"key":"2020070910542302500_CIT0034","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1097\/OLQ.0000000000000445","article-title":"Molecular subtyping and surveillance of resistance genes in Treponema pallidum DNA from patients with secondary and latent syphilis in Hunan, China","volume":"43","author":"Xiao","year":"2016","journal-title":"Sex Transm Dis"},{"key":"2020070910542302500_CIT0035","volume-title":"Breakpoint tables for interpretation of MICs and zone diameters","author":"The European Committee on Antimicrobial Susceptibility Testing","year":"2019"},{"key":"2020070910542302500_CIT0036","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1007\/s40588-016-0028-4","article-title":"Chlamydial antibiotic resistance and treatment failure in veterinary and human medicine","volume":"3","author":"Borel","year":"2016","journal-title":"Curr Clin Microbiol Rep"},{"key":"2020070910542302500_CIT0037","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.1086\/315372","article-title":"Multiple drug-resistant Chlamydia trachomatis associated with clinical treatment failure","volume":"181","author":"Somani","year":"2000","journal-title":"J Infect Dis"},{"key":"2020070910542302500_CIT0038","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1097\/OLQ.0000000000000741","article-title":"Enhanced molecular typing of Treponema pallidum subspecies pallidum strains from 4 Italian Hospitals shows geographical differences in strain type heterogeneity, widespread resistance to macrolides, and lack of mutations associated with doxycycline resistance","volume":"45","author":"Giacani","year":"2018","journal-title":"Sex Transm Dis"},{"key":"2020070910542302500_CIT0039","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1126\/science.281.5375.375","article-title":"Complete genome sequence of Treponema pallidum, the syphilis spirochete","volume":"281","author":"Fraser","year":"1998","journal-title":"Science"},{"key":"2020070910542302500_CIT0040","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1056\/NEJMoa040216","article-title":"Macrolide resistance in Treponema pallidum in the United States and Ireland","volume":"351","author":"Lukehart","year":"2004","journal-title":"N Engl J Med"},{"key":"2020070910542302500_CIT0041","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1128\/AAC.01095-09","article-title":"Global challenge of antibiotic-resistant Treponema pallidum","volume":"54","author":"Stamm","year":"2010","journal-title":"Antimicrob Agents Chemother"},{"key":"2020070910542302500_CIT0042","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1136\/sextrans-2017-053164","article-title":"Detection of markers predictive of macrolide and fluoroquinolone resistance in Mycoplasma genitalium from patients attending sexual health services in England","volume":"94","author":"Pitt","year":"2018","journal-title":"Sex Transm Infect"},{"key":"2020070910542302500_CIT0043","article-title":"High prevalence and antibiotic resistance of M. genitalium infections in MSM on PrEP.","author":"Berc\u0327ot","year":"2019"},{"key":"2020070910542302500_CIT0044","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1186\/1471-2334-13-325","article-title":"Staphylococcus aureus colonization of healthy military service members in the United States and Afghanistan","volume":"13","author":"Vento","year":"2013","journal-title":"BMC Infect Dis"},{"key":"2020070910542302500_CIT0045","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1186\/1471-2334-13-68","article-title":"Multidrug-resistant gram-negative bacteria colonization of healthy US military personnel in the US and Afghanistan","volume":"13","author":"Vento","year":"2013","journal-title":"BMC Infect Dis"},{"key":"2020070910542302500_CIT0046","doi-asserted-by":"crossref","first-page":"488","DOI":"10.3201\/eid1303.060729","article-title":"Methicillin-susceptible, doxycycline-resistant Staphylococcus aureus, C\u00f4te d\u2019Ivoire","volume":"13","author":"Lesens","year":"2007","journal-title":"Emerg Infect Dis"},{"key":"2020070910542302500_CIT0047","doi-asserted-by":"crossref","first-page":"e32","DOI":"10.1097\/OLQ.0000000000000942","article-title":"High interest in doxycycline for sexually transmitted infection post-exposure prophylaxis (doxycycline-PEP) in a multi-city survey of men who have sex with men (MSM) using a social-networking app","volume":"46","author":"Spinelli","year":"2019","journal-title":"Sex Trans Dis"},{"key":"2020070910542302500_CIT0048","doi-asserted-by":"crossref","first-page":"e482","DOI":"10.1016\/S2352-3018(18)30210-8","article-title":"Doxycycline use in MSM taking PrEP","volume":"5","author":"Carveth-Johnson","year":"2018","journal-title":"Lancet HIV"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciz866\/30263988\/ciz866.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/70\/6\/1247\/33478668\/ciz866.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/70\/6\/1247\/33478668\/ciz866.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T19:16:19Z","timestamp":1664219779000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/70\/6\/1247\/5557867"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,1]]},"references-count":48,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2019,9,1]]},"published-print":{"date-parts":[[2020,3,3]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciz866","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,3,15]]},"published":{"date-parts":[[2019,9,1]]}}}