MPS advises of need for better awareness of cauda equina red flag symptoms

MPS advises of need for better awareness of cauda equina red flag symptoms

May 9 2018 The Medical Protection Society is advising doctors of a revision to the NICE Clinical...

Anticholinergics linked to increased risk of dementia

Anticholinergics linked to increased risk of dementia

April 30 2018 Anticholinergic drugs used in helping control some involuntary muscle movement...

Women of childbearing potential must be on Pregnancy Prevention Programme if taking valproate

Women of childbearing potential must be on Pregnancy Prevention Programme if taking valproate

April 27 2018 Women and girls of childbearing potential must no longer take valproate medicines...

Buprenorphine may be safer than methadone in opioid substitute therapy, study suggests

Buprenorphine may be safer than methadone in opioid substitute therapy, study suggests

April 23 2018 Buprenorphine has been found to have lower rates of overdose death than methadone...

Class of diabetes drug linked to increased risk of irritable bowel disease

Class of diabetes drug linked to increased risk of irritable bowel disease

March 29 2018 A study has shown that dipeptidylpeptidase-4 inhibitors may increase the risk of...

  • MPS advises of need for better awareness of cauda equina red flag symptoms

    MPS advises of need for better awareness of cauda equina red flag symptoms

    Wednesday, 09 May 2018 16:01
  • Anticholinergics linked to increased risk of dementia

    Anticholinergics linked to increased risk of dementia

    Monday, 30 April 2018 12:20
  • Women of childbearing potential must be on Pregnancy Prevention Programme if taking valproate

    Women of childbearing potential must be on Pregnancy Prevention Programme if taking valproate

    Friday, 27 April 2018 12:12
  • Buprenorphine may be safer than methadone in opioid substitute therapy, study suggests

    Buprenorphine may be safer than methadone in opioid substitute therapy, study suggests

    Monday, 23 April 2018 16:59
  • Class of diabetes drug linked to increased risk of irritable bowel disease

    Class of diabetes drug linked to increased risk of irritable bowel disease

    Thursday, 29 March 2018 11:49

a man taking medication imageNovember 10 2017

Doxycycline should not be used for post-exposure prophylaxis (PEP) for sexually transmitted infections, says new guidance. Any potential benefits are “outweighed by the considerable potential for antibiotic resistance to develop in STIs and other bacteria.”

Members of the public who may be searching online for doxycycline PEP should be advised that antibiotics should only be prescribed by a health professional and use diagnostic testing.

A position statement issued jointly by Public Health England and the British Association for Sexual Health and HIV (BASHH) says more research is needed to assess the wider impact of prophylactic doxycycline on antimicrobial resistance (AMR) at an individual and population level. Instead, the organisations state: “We recommend the use of antibiotics as prescribed by a healthcare professional and as indicated by the results of a suitable diagnostic test.”

The statement refers to a study published earlier this year which had found that doxycycline PEP had halved the rates of bacterial STIs in men who have sex with men (MSM), in an extension of the French IPERGAY trial. “Many of the online companies selling HIV Pre-exposure Prophylaxis (PrEP) in the form of tenofovir disoproxil fumarate 300mg / emtricitabine 200mg are now making doxycycline available to UK buyers,” says the statement.

“A high rate of STIs without doxycycline PEP was shown (69.7 events per 100-person years of follow-up) and the antibiotic strategy showed an overall reduction in STI incidence of 47%. There was a significant decrease in chlamydia and syphilis incidence with reductions of 70 and 73% respectively in intent to treat analyses but no clear benefit was shown for gonorrhoea, likely due to the high rate of doxycycline resistance already developed.”

The PHE /BASHH statement adds: “For those at risk, following condomless sex, we recommend STI testing at appropriate window periods and the treatment of any infections identified should be prescribed by a healthcare professional and be in line with published national guidance. We recommend that the use of doxycycline PEP should be restricted to the research setting at present.”

Links:
PHE announcement       
BASHH announcement  
PHE/BASHH ‘Position Statement on Doxycycline as PostExposure Prophylaxis for Sexually Transmitted Infections’ November 2017                  

Clinical News

May 23 2018 Over 2,000 patients were removed from GP lists due to allegations of violence or threats in 2017. A further 10,000 were removed due to a break down in the relationship between the GP and...
May 18 2018 New guidance to support the integration of community pharmacy services into primary care homes (PCHs) has been published.  The National Association of Primary Care’s report looks at ways...