Trial reportNature medicine2025
Impact of doxycycline post-exposure prophylaxis for sexually transmitted infections on the gut microbiome and antimicrobial resistome.
Trial report in Nature medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06778083 (STI Prophylaxis and Emergence of Antimicrobial Resistance), which is not on this map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
STI Prophylaxis and Emergence of Antimicrobial Resistance
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association Between Doxycycline Chemoprophylaxis and the Development of Gastrointestinal Conditions in Military Personnel: A Systematic Review.Military medicine · 2026Pooled it
- Impact of doxycycline pre-exposure prophylaxis (doxyPrEP) for sexually transmitted infections on the microbiome of men who have sex with men on HIV PrEP.Nature communications · 2025Trial
- Doxycycline Postexposure Prophylaxis May Dramatically Reduce Syphilis Among Gay, Bisexual, and Other Men Who Have Sex With Men: A Modeling Study.Sexually transmitted diseases · 2026Article
- Real-world analysis of depression-related adverse events associated with the adsorbed anthrax vaccine: integrating pharmacovigilance signals, machine learning risk prediction, and transcriptomic mechanisms.Infectious diseases of poverty · 2026Article
- Sustained Effectiveness of Doxycycline Post-Exposure-Prophylaxis in a Large Sexual Health Clinic Over 96 Weeks: An Interrupted Time Series Analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Comparing Phenotypic Susceptibility Profiles of Neisseria gonorrhoeae for Tetracycline and Doxycycline.Sexually transmitted diseases · 2026Article
- A deformylase inhibitor expands therapeutic options for Lyme disease.Research square · 2026Article
- Post-exposure prophylaxis with antibiotics to prevent sexually transmitted infections.The Cochrane database of systematic reviews · 2026Article
- Appropriate use of Doxy-PEP and inappropriate antibiotic self-medication for STI management: insights from a LGBTQIA+ survey in Italy.BMC public health · 2026Article
- Empiric azithromycin alters the upper respiratory microbiome and resistome without anti-inflammatory benefit in COVID-19.Nature microbiology · 2026Article
- Post-Exposure Prophylaxis Prescribing Practices in a Lyme Disease-Endemic Area.Infectious disease reports · 2026Article
- World Health Organization-Recommended Periodic Presumptive Treatment Versus Doxycycline Post-Exposure Prophylaxis for Sexually Transmitted Infection Control Among Men Who Have Sex With Men in Kenya: Protocol for a Randomized Controlled Trial.JMIR research protocols · 2026Article
- Immunotherapies for Central Nervous System Tumors and their Neurologic Complications.Current neurology and neuroscience reports · 2026Review
- A Review of Doxycycline Post-Exposure Prophylaxis and Its Implications for Antimicrobial Resistance and the Human Microbiome.Infectious diseases and therapy · 2026Review
- Southern African HIV Clinicians Society guideline on doxycycline post-exposure prophylaxis to prevent bacterial sexually transmitted infections.Southern African journal of HIV medicine · 2026Article
- The intersection of sexually transmitted infections and antimicrobial stewardship: opportunities for synergy.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- High prevalence of tetracycline resistance inEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2026Article
- Sexually transmitted enteric infections in men who have sex with men.Clinical microbiology reviews · 2025Review
- Post-exposure prophylaxis with doxycycline (DoxyPEP) to prevent STIs in a real-world setting: the PRIDOX study.The Journal of antimicrobial chemotherapy · 2025Article
- Doxycycline Postexposure Prophylaxis Is Effective and Highly Acceptable in an Urban Public Sexually Transmitted Disease Clinic: Philadelphia, 2019-2023.Sexually transmitted diseases · 2025Article
Corrections and comments
- Update of
Authors and funding
15 authors.
Funding
Abstract
Doxycycline post-exposure prophylaxis (doxy-PEP) reduces bacterial sexually transmitted infections among men who have sex with men and transgender women. Although poised for widespread clinical implementation, the impact of doxy-PEP on antimicrobial resistance remains a primary concern as its effects on the gut microbiome and resistome, or the antimicrobial resistance genes (ARGs) present in the gut microbiome, are unknown. To investigate these effects, we studied participants from the DoxyPEP trial, a randomized clinical trial comparing doxy-PEP use, a one-time doxycycline 200-mg dose taken after condomless sex (DP arm, n = 100), to standard of care (SOC arm, n = 50) among men who have sex with men and transgender women. From self-collected rectal swabs at enrollment (day-0) and after 6 months (month-6), we performed metagenomic DNA sequencing (DNA-seq) or metatranscriptomic RNA sequencing (RNA-seq). DNA-seq data were analyzable from 127 samples derived from 89 participants, and RNA-seq data were analyzable from 86 samples derived from 70 participants. We compared the bacterial microbiome and resistome between the two study arms and over time. The median number of doxycycline doses taken since enrollment by participants with DNA-seq data was zero (interquartile range (IQR): 0-7 doses) for the SOC arm and 42 (IQR: 27-64 doses) for the DP arm. Tetracycline ARGs were detected in all day-0 DNA-seq samples and in 85% of day-0 RNA-seq samples. The proportional mass of tetracycline ARGs in the resistome increased between day-0 and month-6 in DP participants from 46% to 51% in the metagenome (P = 2.3 × 10
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.