The proposed use of the antibiotic doxycycline to combat sexually transmitted infections (STIs) like syphilis, gonorrhea, and chlamydia has sparked varied reactions among scientists.
This suggestion comes from the Centers for Disease Control and Prevention (CDC) in the United States, based on a study conducted between 2020 and 2022 by researchers at the University of California, San Francisco (UCSF) and the University of Washington.
The study involved 501 adults at four clinic sites in San Francisco and Seattle.
The researchers, in their recent report, revealed a 66% reduction in the occurrence of syphilis, gonorrhea, and chlamydia among participants who took doxycycline within 72 hours of unprotected intercourse.
Dr. Rony Bahatungire, the acting commissioner for clinical services at the Ugandan Health Ministry, expressed cautious interest in the proposal.
He mentioned they would assess the evidence and consider incorporating it into Uganda’s clinical guidelines if proven effective.
A 2021 study in Uganda by Ms. Veronicah Masanja indicated that self-reported STIs have remained at persistently high levels, with an increase from 22% in 2006 to 27% in 2011.
The study reported up to 1.5 million cases of STIs between 2015 and 2017, emphasizing the need for STI control as a public health priority.
However, Dr. Ivan Kisuule, a physician at Mulago National Referral Hospital and acting deputy registrar at the Uganda Medical and Dental Practitioners Council, raised concerns about adopting doxycycline for prevention.
He warned that its prophylactic use could lead to misuse by the public and result in bacterial resistance. The current Uganda Clinical Guidelines from 2022 recommend doxycycline for treatment rather than prophylaxis against STIs.
This concern aligns with a recent global report revealing that infections caused by drug-resistant bacteria caused more deaths in 2019 than HIV/AIDS and malaria combined.
The National Health Institute (NIH) of America, which funded the study, also noted the potential for antibacterial resistance in their findings.
The post-exposure approach, called doxy-PEP, did reduce STI incidence but showed a slight increase in antibacterial resistance, prompting the need for further exploration.
Scientists emphasize that proven methods for preventing STIs include condom use and abstinence.