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45 years of tetracycline post exposure prophylaxis for STIs and the risk of tetracycline resistance: a systematic review and meta-analysis.
Vanbaelen, Thibaut; Manoharan-Basil, Sheeba Santhini; Kenyon, Chris.
Afiliação
  • Vanbaelen T; STI Unit, Department of Clinical Sciences, Institute of Tropical Medicine, 2000, Antwerp, Belgium.
  • Manoharan-Basil SS; STI Unit, Department of Clinical Sciences, Institute of Tropical Medicine, 2000, Antwerp, Belgium.
  • Kenyon C; STI Unit, Department of Clinical Sciences, Institute of Tropical Medicine, 2000, Antwerp, Belgium. ckenyon@itg.be.
BMC Infect Dis ; 24(1): 376, 2024 Apr 04.
Article em En | MEDLINE | ID: mdl-38575877
ABSTRACT
There is considerable interest in the use of doxycycline post exposure prophylaxis (PEP) to reduce the incidence of bacterial sexually transmitted infections (STIs). An important concern is that this could select for tetracycline resistance in these STIs and other species. We searched PubMed and Google Scholar, (1948-2023) for randomized controlled trials comparing tetracycline PEP with non-tetracycline controls. The primary outcome was antimicrobial resistance (AMR) to tetracyclines in all bacterial species with available data. Our search yielded 140 studies, of which three met the inclusion criteria. Tetracycline PEP was associated with an increasedprevalence of tetracycline resistance in Neisseria gonorrhoeae, but this effect was not statistically significant (Pooled OR 2.3, 95% CI 0.9-3.4). PEP had a marked effect on the N. gonorrhoeae tetracycline MIC distribution in the one study where this was assessed. Prophylactic efficacy was 100% at low MICs and 0% at high MICs. In the one study where this was assessed, PEP resulted in a significant increase in tetracycline resistance in commensal Neisseria species compared to the control group (OR 2.9, 95% CI 1.5-5.5) but no significant effect on the prevalence of tetracycline resistance in Staphylococcus aureus. The available evidence suggests that PEP with tetracyclines could be associated with selecting tetracycline resistance in N. gonorrhoeae and commensal Neisseria species.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Gonorreia / Infecções Sexualmente Transmissíveis Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Gonorreia / Infecções Sexualmente Transmissíveis Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article