What to know
- Presentation Day/Time: Wednesday, April 23, 9:00–10:25 am
- Presenter: Dumbani Kayira, MBBS, MSc, EIS officer assigned to the National Center for Emerging and Zoonotic Infectious Diseases, Division of Healthcare Quality Promotion
What did we do?
- In June 2024, CDC recommended doxycycline postexposure prophylaxis (doxy PEP) for bacterial sexually transmitted infection (STI) prevention among men who have sex with men. To describe doxycycline prescribing trends prior to national guideline release and after implementation of local doxy PEP policies, we compared changes in doxycycline prescribing rates between 2017 and 2023 nationally and for two counties that were early doxy PEP implementers.
What did we find?
- Between 2017 and 2023, the national doxycycline prescribing rate increased by 43%. San Francisco and Philadelphia counties experienced larger increases (49% and 64%, respectively).
- While we found small differences in the increase in doxycycline prescriptions between men and women nationally (45% and 42% respectively), larger differences were observed for men compared to women in San Francisco County (63% vs. 37%) and Philadelphia County (76% vs. 55%).
- The largest increases in prescribing were among men ages 20–39 years in San Francisco County (142%) and Philadelphia County (126%), compared to 67% nationally.
Why does it matter?
- While the increase in outpatient doxycycline prescribing is likely a result of multiple factors, doxy PEP early adopter counties experienced larger increases compared to national changes, particularly among men ages 20–39 years.
- Doxy PEP represents a new approach to addressing STI prevention in MSM with potential to reduce new infections.
- With increasing antibiotic use, potential risks related to the development of resistance will need to be monitored as these guidelines are implemented.
Abstract Category: Doxycycline Prescribing for STIs