Morning-after pills for STDs worry doctors

Doxycycline is an old drug against several different bacterial diseases such as Lyme disease and Chlamydia. But abroad, the medicine has started to be used as a morning-after pill against venereal diseases. It is then called doxy-pep.

Instead of taking a full course when the infection is established, you take two tablets after unprotected sex, just in case you have been infected. And it seems to work for some.

Differences in effect

– American studies on gay guys have shown a 70 percent reduction for syphilis and chlamydia. Somewhat surprisingly, it also had an effect against gonorrhea, says senior physician Finn Filén at Södersjukhuset’s Venhälsan.

However, a study on women in Kenya did not show the same protective effect. You don’t know what causes it.

The American CDC recently came up with a proposal for guidelines for how doxy-pep should be used. Men and trans women who have sex with men can take 200 milligrams within 72 hours of unprotected sex with a partner who has had gonorrhea, chlamydia, or syphilis in the past year.

Not printed in Sweden

The recommendation has led to a greatly increased demand for doxy-pep. A study in the Netherlands showed a tenfold increase among gay men in the past year.

– Now we notice the demand also among our patients and colleagues who call and ask. But we are a bit restrained, says Finn Filén.

The risk that doxy-pep increases antibiotic resistance in society means that Swedish doctors do not prescribe it, despite the fact that certain venereal diseases have increased sharply in Sweden. At the same time, Swedish doctors are concerned that doxyclin is both cheap and easily available online and is sold without a prescription abroad.

– It can give an increased resistance also against other strains of bacteria such as staphylococci. It would be a disaster if it took hold, says doctor Anne González at Stockholm’s clinic for sexual health.

True and false about STDs – do you recognize the myths?

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