These authors contributed equally to this article.
Version 1
: Received: 28 September 2023 / Approved: 28 September 2023 / Online: 29 September 2023 (04:50:28 CEST)
How to cite:
Thibaut., V.; Manoharan-Basil, S.; Kenyon, C. 45 Years of Tetracycline Post Exposure Prophylaxis for STIs and the Risk of Tetracycline Resistance: A Systematic Review and Meta-Analysis. Preprints2023, 2023092020. https://doi.org/10.20944/preprints202309.2020.v1
Thibaut., V.; Manoharan-Basil, S.; Kenyon, C. 45 Years of Tetracycline Post Exposure Prophylaxis for STIs and the Risk of Tetracycline Resistance: A Systematic Review and Meta-Analysis. Preprints 2023, 2023092020. https://doi.org/10.20944/preprints202309.2020.v1
Thibaut., V.; Manoharan-Basil, S.; Kenyon, C. 45 Years of Tetracycline Post Exposure Prophylaxis for STIs and the Risk of Tetracycline Resistance: A Systematic Review and Meta-Analysis. Preprints2023, 2023092020. https://doi.org/10.20944/preprints202309.2020.v1
APA Style
Thibaut., V., Manoharan-Basil, S., & Kenyon, C. (2023). 45 Years of Tetracycline Post Exposure Prophylaxis for STIs and the Risk of Tetracycline Resistance: A Systematic Review and Meta-Analysis. Preprints. https://doi.org/10.20944/preprints202309.2020.v1
Chicago/Turabian Style
Thibaut., V., Sheeba Manoharan-Basil and Chris Kenyon. 2023 "45 Years of Tetracycline Post Exposure Prophylaxis for STIs and the Risk of Tetracycline Resistance: A Systematic Review and Meta-Analysis" Preprints. https://doi.org/10.20944/preprints202309.2020.v1
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 had no effect on the prevalence of tetracycline resistance in Neisseria gonorrhoeae in any of the three trials or the pooled estimates. PEP did, however, have a marked effect on the 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 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.
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
