Information for Clinicians
Doxycycline as STI PEP: Considerations for Individuals and Healthcare Providers of Gay or Bisexual Men or Transgender Women
As CDC and others work quickly to evaluate data to inform clinical guidance on the safe and effective use of post-exposure prophylaxis with doxycycline (also called doxy as PEP) to prevent gonorrhea, chlamydia, and syphilis, we acknowledge there are individuals and clinicians who are already engaged in the off-label use of doxycycline as bacterial STI post-exposure prophylaxis or considering it. As such, we are providing the following considerations to inform those decisions:
- Current efficacy data only applies to gay and bisexual men and transgender women. Studies among heterosexual cis-gender women are ongoing.
- Doxycycline 200 mg administered within 24-72 hours of condomless sex was the regimen evaluated in this study. Other antibiotics should not be considered for PEP.
- In addition to informing patients about the potential STI prevention benefits of doxy as PEP, providers should also counsel patients about potential adverse side effects of doxycycline including phototoxicity, gastrointestinal symptoms, and more rarely esophageal ulceration.
- Providers should continue to screen, test, and treat for bacterial STIs in accordance with CDC’s STI Treatment Guidelines and CDC’s PrEP for the Prevention of HIV guidelines, even among people who may be using doxycycline as PEP or PrEP.