{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T22:39:04Z","timestamp":1775515144838,"version":"3.50.1"},"reference-count":67,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Over the past two decades, the global incidence of sexually transmitted infections (STIs) such as gonorrhea, chlamydia, and syphilis have increased significantly, particularly among cisgender men who have sex with men (MSM) and transgender women (TGW). This rise in STIs has spurred interest in new preventive measures, including doxycycline post-exposure prophylaxis (DoxyPEP). Clinical trials in the United States and France have demonstrated the effectiveness of DoxyPEP in reducing both chlamydia and syphilis incidence among MSM and TGW; although, its efficacy against gonorrhea remains limited, and it was further found to be ineffective among cisgender women in Kenya. Due to the promising results, the CDC and the German STI Society have incorporated DoxyPEP into their guidelines for specific high-risk groups. However, the broader implementation of DoxyPEP presents several challenges and ethical concerns. Key issues involve the potential development of antimicrobial resistance, particularly among common STI pathogens like C. trachomatis, M. genitalium, and N. gonorrhoeae, as well as other bacteria such as S. aureus and K. pneumoniae. Additionally, questions concerning equitable healthcare access, the potential impact on adherence to safer sex practices, and broader public health implications warrant careful consideration. Addressing these challenges necessitates a careful balance between the benefits and risks of DoxyPEP, as well as the implementation of strategies to mitigate negative outcomes while maximizing the impact on public health. Lastly, future research should explore the integration of DoxyPEP with other preventive strategies, such as vaccines, to enhance its effectiveness and reduce the global burden of STIs.<\/jats:p>","DOI":"10.3390\/antibiotics13121183","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T06:24:44Z","timestamp":1733379884000},"page":"1183","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["From Cure to Prevention: Doxycycline\u2019s Potential in Prophylaxis for Sexually Transmitted Infections"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7113-9259","authenticated-orcid":false,"given":"James","family":"Bird","sequence":"first","affiliation":[{"name":"Department of Basic and Clinical Sciences, University of Nicosia, Nicosia 2417, Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6473-6689","authenticated-orcid":false,"given":"Basil","family":"Alawyia","sequence":"additional","affiliation":[{"name":"Department of Basic and Clinical Sciences, University of Nicosia, Nicosia 2417, Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6981-8535","authenticated-orcid":false,"given":"Nikolaos","family":"Spernovasilis","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, German Medical Institute, Limassol 4108, Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9762-7453","authenticated-orcid":false,"given":"Danny","family":"Alon-Ellenbogen","sequence":"additional","affiliation":[{"name":"Department of Basic and Clinical Sciences, University of Nicosia, Nicosia 2417, Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1093\/cid\/ciz866","article-title":"Doxycycline Prophylaxis for Bacterial Sexually Transmitted Infections","volume":"70","author":"Grant","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s12976-017-0062-9","article-title":"Test-and-Treat Approach to HIV\/AIDS: A Primer for Mathematical Modeling","volume":"14","author":"Nah","year":"2017","journal-title":"Theor. Biol. Med. Model."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1097\/QAD.0b013e32834ed991","article-title":"Periodic Presumptive Treatment of Curable Sexually Transmitted Infections among Sex Workers: A Systematic Review","volume":"26","author":"Steen","year":"2012","journal-title":"AIDS"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1021\/acsinfecdis.8b00043","article-title":"Doxycycline Prophylaxis for Bacterial Sexually Transmitted Infections: Promises and Perils","volume":"4","author":"Siguier","year":"2018","journal-title":"ACS Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2357924","DOI":"10.1080\/21645515.2024.2357924","article-title":"4CMenB Journey to the 10-Year Anniversary and Beyond","volume":"20","author":"Abitbol","year":"2024","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_6","unstructured":"World Health Organization (2021). Global Progress Report on HIV, Viral Hepatitis and Sexually Transmitted Infections, 2021. Accountability for the Global Health Sector Strategies 2016\u20132021, World Health Organization. Technical Report."},{"key":"ref_7","unstructured":"United States Center for Disease Control and Prevention (2024). Sexually Transmitted Infections Surveillance 2022, Technical Report."},{"key":"ref_8","unstructured":"European Centre for Disease Prevention and Control (2024). Chlamydia, Technical Report."},{"key":"ref_9","unstructured":"European Centre for Disease Prevention and Control (2024). Gonorrhoea, Technical Report."},{"key":"ref_10","unstructured":"European Centre for Disease Prevention and Control (2024). Syphilis, Technical Report."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/j.amepre.2021.03.009","article-title":"Impact of the COVID-19 Pandemic on Chlamydia and Gonorrhea Screening in the U.S","volume":"61","author":"Pinto","year":"2021","journal-title":"Am. J. Prev. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1093\/infdis\/jiad047","article-title":"The Estimated Lifetime Quality-Adjusted Life-Years Lost Due to Chlamydia, Gonorrhea, and Trichomoniasis in the United States in 2018","volume":"227","author":"Li","year":"2023","journal-title":"J. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e0210421","DOI":"10.1371\/journal.pone.0210421","article-title":"Marked Reduction in Fertility among African Women with Urogenital Infections: A Prospective Cohort Study","volume":"14","author":"Perslev","year":"2019","journal-title":"PLoS ONE"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.cophys.2020.07.021","article-title":"Mucosal Immunity and HIV Acquisition in Women","volume":"19","author":"Parthasarathy","year":"2021","journal-title":"Curr. Opin. Physiol."},{"key":"ref_15","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":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr7004a1","article-title":"Sexually Transmitted Infections Treatment Guidelines, 2021","volume":"70","author":"Workowski","year":"2021","journal-title":"MMWR Recomm. Rep."},{"key":"ref_17","first-page":"100737","article-title":"Treatment of Bacterial Sexually Transmitted Infections in Europe: Gonorrhoea, Mycoplasma Genitalium, and Syphilis","volume":"34","author":"Giacani","year":"2023","journal-title":"Lancet Reg. Health"},{"key":"ref_18","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":"ref_19","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1056\/NEJMoa053884","article-title":"Postexposure Treatment with Doxycycline for the Prevention of Tick-Borne Relapsing Fever","volume":"355","author":"Hasin","year":"2006","journal-title":"N. Engl. J. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1864","DOI":"10.4269\/ajtmh.20-0241","article-title":"Doxycycline Malaria Prophylaxis Impact on Risk of Travelers\u2019 Diarrhea among International Travelers","volume":"103","author":"Lago","year":"2020","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1001\/jama.2024.2978","article-title":"Syphilis Has Surged for Reasons That Go Beyond the Pathogen That Causes It","volume":"332","author":"Rubin","year":"2024","journal-title":"JAMA"},{"key":"ref_22","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":"ref_23","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1016\/j.clinthera.2005.09.005","article-title":"Safety of Doxycycline and Minocycline: A Systematic Review","volume":"27","author":"Smith","year":"2005","journal-title":"Clin. Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/S0029-7844(97)00005-7","article-title":"Teratogenic Study of Doxycycline","volume":"89","author":"Czeizel","year":"1997","journal-title":"Obstet. Gynecol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1517\/14740338.2016.1133584","article-title":"Revisiting Doxycycline in Pregnancy and Early Childhood\u2013Time to Rebuild Its Reputation?","volume":"15","author":"Cross","year":"2016","journal-title":"Expert Opin. Drug Saf."},{"key":"ref_26","first-page":"315","article-title":"The Role of Mycoplasma among 81 Consecutive Pregnancies: A Prospective Study","volume":"25","author":"Horne","year":"1980","journal-title":"Int. J. Fertil."},{"key":"ref_27","unstructured":"Joint Formulary Committee (2024). British National Formulary, BMJ."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1016\/S1473-3099(24)00236-6","article-title":"Doxycycline Prophylaxis and Meningococcal Group B Vaccine to Prevent Bacterial Sexually Transmitted Infections in France (ANRS 174 DOXYVAC): A Multicentre, Open-Label, Randomised Trial with a 2 \u00d7 2 Factorial Design","volume":"24","author":"Molina","year":"2024","journal-title":"Lancet Infect. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2331","DOI":"10.1056\/NEJMoa2304007","article-title":"Doxycycline Prophylaxis to Prevent Sexually Transmitted Infections in Women","volume":"389","author":"Stewart","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_30","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":"ref_31","doi-asserted-by":"crossref","first-page":"107186","DOI":"10.1016\/j.ijid.2024.107186","article-title":"Doxycycline Prophylaxis for the Prevention of Sexually Transmitted Infections: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"147","author":"Szondy","year":"2024","journal-title":"Int. J. Infect. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1186\/s12879-024-09275-3","article-title":"45 Years of Tetracycline Post Exposure Prophylaxis for STIs and the Risk of Tetracycline Resistance: A Systematic Review and Meta-Analysis","volume":"24","author":"Vanbaelen","year":"2024","journal-title":"BMC Infect. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1208014","DOI":"10.3389\/fmicb.2023.1208014","article-title":"Doxycycline PEP Can Induce Doxycycline Resistance in Klebsiella Pneumoniae in a Galleria Mellonella Model of PEP","volume":"14","author":"Kenyon","year":"2023","journal-title":"Front. Microbiol."},{"key":"ref_34","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":"ref_35","first-page":"2300621","article-title":"Using Doxycycline for Prophylaxis of Bacterial Sexually Transmitted Infections: Considerations for the European Union and European Economic Area","volume":"28","author":"Plachouras","year":"2023","journal-title":"Eurosurveillance"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.1128\/JCM.00125-13","article-title":"Development of Doxycycline MIC and Disk Diffusion Interpretive Breakpoints and Revision of Tetracycline Breakpoints for Streptococcus Pneumoniae","volume":"51","author":"Dallas","year":"2020","journal-title":"J. Clin. Microbiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"106974","DOI":"10.1016\/j.ijid.2024.02.017","article-title":"Doxycycline Post-Exposure Prophylaxis Could Theoretically Select for Resistance to Various Antimicrobials in 19 Pathobionts: An in Silico Analysis","volume":"142","author":"Kenyon","year":"2024","journal-title":"Int. J. Infect. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e268","DOI":"10.1016\/S1473-3099(23)00359-6","article-title":"Selection of Neisseria Gonorrhoeae Ceftriaxone Resistance Using Doxycycline Post-Exposure Prophylaxis","volume":"23","author":"Whiley","year":"2023","journal-title":"Lancet Infect. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/s12941-021-00465-4","article-title":"An Overview of Genes and Mutations Associated with Chlamydiae Species\u2019 Resistance to Antibiotics","volume":"20","author":"Benamri","year":"2021","journal-title":"Ann. Clin. Microbiol. Antimicrob."},{"key":"ref_40","first-page":"1","article-title":"Doxycycline Post-Exposure Prophylaxis for Bacterial Sexually Transmitted Infections: The Current Landscape and Future Directions","volume":"22","author":"Mayer","year":"2024","journal-title":"Curr. HIV\/AIDS Rep."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1097\/OLQ.0b013e31815e41a3","article-title":"The Arrested Immunity Hypothesis and the Epidemiology of Chlamydia Control","volume":"35","author":"Brunham","year":"2008","journal-title":"Sex. Transm. Dis."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.tpb.2014.01.005","article-title":"The Arrested Immunity Hypothesis in an Immunoepidemiological Model of Chlamydia Transmission","volume":"93","author":"Vickers","year":"2014","journal-title":"Theor. Popul. Biol."},{"key":"ref_43","unstructured":"Saunders, J.M., Kohli, M., Medland, N.A., and Fifer, H. (2021). Position Statement on Doxycycline as Prophylaxis for Sexually Transmitted Infections 2021 Update, BASHH."},{"key":"ref_44","unstructured":"San Francisco Department of Public Health (2022). Doxycycline Post-Exposure Prophylaxis Reduces Incidence of Sexually Transmitted Infections."},{"key":"ref_45","unstructured":"Quinn, C., and Pathela, P. (2023). Doxycycline Post-Exposure Prophylaxis (Doxy-PEP) to Prevent Bacterial Sexually Transmitted Infections, New York City Department of Health and Mental Hygeine. Technical Report."},{"key":"ref_46","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":"ref_47","first-page":"466","article-title":"Position Statement of the German STI Society on the Prophylactic Use of Doxycycline to Prevent STIs (Doxy-PEP, Doxy-PrEP)","volume":"22","author":"Werner","year":"2024","journal-title":"JDDG J. Der Dtsch. Dermatol. Ges."},{"key":"ref_48","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":"ref_49","unstructured":"European AIDS Clinical Society (2024). EACS Guidelines: Version 12.1, European AIDS Clinical Society. Technical Report 12.1."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1177\/09564624241273801","article-title":"IUSTI Europe Position Statement on Use of DoxyPEP: June 2024","volume":"35","author":"Sherrard","year":"2024","journal-title":"Int. J. STD AIDS"},{"key":"ref_51","unstructured":"C.R.O.I (2024, August 23). STIs in San Francisco Have Fallen Since DoxyPEP Roll-Out, Tuesday 5 March 2024. Available online: https:\/\/www.aidsmap.com\/bulletin\/conference-news\/croi-2024\/5-march-2024."},{"key":"ref_52","first-page":"13498","article-title":"Doxycycline Prophylaxis for Bacterial Sexually Transmitted Infections: Evaluating Effectiveness, Risks, and Challenges","volume":"82","author":"Monteiro","year":"2024","journal-title":"Port. J. Dermatol. Venereol."},{"key":"ref_53","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":"ref_54","first-page":"566","article-title":"Doxycycline Postexposure Prophylaxis for Prevention of Sexually Transmitted Infections","volume":"31","author":"Cannon","year":"2023","journal-title":"Top. Antivir. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"ciae062","DOI":"10.1093\/cid\/ciae062","article-title":"Filling in the Gaps: Updates on Doxycycline Prophylaxis for Bacterial Sexually Transmitted Infections","volume":"9","author":"Hazra","year":"2024","journal-title":"Clin. Infect. Dis."},{"key":"ref_56","unstructured":"Kwach, B., Kwena, Z., Violette, L., Odoyo, J., Oware, K., Simoni, J., Bukusi, E., Baeten, J., and Stewart, J. (2024, January 20\u201326). Understanding Barriers and Facilitators to Doxycycline Post-Exposure Prophylaxis Adherence among Young Women in Western Kenya: A Qualitative Study. Proceedings of the 24th International AIDS Conference, Munich, Germany."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1097\/QAI.0000000000002025","article-title":"Trends in Number and Composition of Sex Partners Among Men Who Have Sex With Men in the United States, National HIV Behavioral Surveillance, 2008\u20132014","volume":"81","author":"Rosenberg","year":"2019","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1186\/1471-2458-11-189","article-title":"Number of Casual Male Sexual Partners and Associated Factors among Men Who Have Sex with Men: Results from the National HIV Behavioral Surveillance System","volume":"11","author":"Rosenberg","year":"2011","journal-title":"BMC Public Health"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1186\/1471-2334-12-114","article-title":"Current Practices of Partner Notification among MSM with HIV, Gonorrhoea and Syphilis in the Netherlands: An Urgent Need for Improvement","volume":"12","author":"Schreuder","year":"2012","journal-title":"BMC Infect. Dis."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e233","DOI":"10.1016\/S2352-3018(23)00299-0","article-title":"Effect of Screening for Neisseria Gonorrhoeae and Chlamydia Trachomatis on Incidence of These Infections in Men Who Have Sex with Men and Transgender Women Taking HIV Pre-Exposure Prophylaxis (the Gonoscreen Study): Results from a Randomised, Multicentre, Controlled Trial","volume":"11","author":"Vanbaelen","year":"2024","journal-title":"Lancet HIV"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2299","DOI":"10.1007\/s10461-021-03573-6","article-title":"A Trend Analysis of Condom Use in Spanish Young People over the Two Past Decades, 1999\u20132020","volume":"26","year":"2022","journal-title":"AIDS Behav."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e104350","DOI":"10.1371\/journal.pone.0104350","article-title":"Trends in Condom Use and Risk Behaviours after Sexual Exposure to HIV: A Seven-Year Observational Study","volume":"9","author":"Casalino","year":"2014","journal-title":"PLoS ONE"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1007\/s10461-018-2300-5","article-title":"The Context of Sexual Risk Behaviour Among Men Who Have Sex with Men Seeking PrEP, and the Impact of PrEP on Sexual Behaviour","volume":"23","author":"Gafos","year":"2019","journal-title":"AIDS Behav."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1097\/QAD.0000000000001874","article-title":"Change in Sexual Risk Behaviour after 6 Months of Pre-Exposure Prophylaxis Use: Results from the Amsterdam Pre-Exposure Prophylaxis Demonstration Project","volume":"32","author":"Hoornenborg","year":"2018","journal-title":"Aids"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1016\/S0140-6736(17)31449-6","article-title":"Effectiveness of a Group B Outer Membrane Vesicle Meningococcal Vaccine against Gonorrhoea in New Zealand: A Retrospective Case-Control Study","volume":"390","author":"Paynter","year":"2017","journal-title":"Lancet"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1016\/S1473-3099(21)00812-4","article-title":"Effectiveness of a Serogroup B Outer Membrane Vesicle Meningococcal Vaccine against Gonorrhoea: A Retrospective Observational Study","volume":"22","author":"Abara","year":"2022","journal-title":"Lancet Infect. Dis."},{"key":"ref_67","first-page":"CMT.S2035","article-title":"Safety and Efficacy Review of Doxycycline","volume":"1","author":"Holmes","year":"2009","journal-title":"Clin. Med. Ther."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/13\/12\/1183\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:47:40Z","timestamp":1760114860000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/13\/12\/1183"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,5]]},"references-count":67,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["antibiotics13121183"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics13121183","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,5]]}}}