this post was submitted on 02 Oct 2023
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U.S. health officials plan to endorse a common antibiotic as a morning-after pill that gay and bisexual men can use to try to avoid some increasingly common sexually transmitted diseases.

The proposed CDC guideline was released Monday, and officials will move to finalize it after a 45-day public comment period. With STD rates rising to record levels, “more tools are desperately needed,” said Dr. Jonathan Mermin of the Centers for Disease Control and Prevention.

The proposal comes after studies found some people who took the antibiotic doxycycline within three days of unprotected sex were far less likely to get chlamydia, syphilis or gonorrhea compared with people who did not take the pills after sex.

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[–] ExRedditor1928 21 points 1 year ago

I don't know much about medicine, but isn't there a whole thing going on about overprescribing antibiotics causing diseases to become immune to them? Wouldn't this escalate that?

[–] [email protected] 11 points 1 year ago* (last edited 1 year ago) (1 children)

as a morning-after pill that gay and bisexual men can use.…

…The guideline is specific to the group that has been most studied — gay and bisexual men and transgender women who had a STD in the previous 12 months and were at high risk to get infected again.

There’s less evidence that the approach works for other people, including heterosexual men and women. That could change as more research is done, said Mermin, who oversees the CDC’s STD efforts.

Oh. Uhh. I..didn't realize we'd swung back around to "only gay people get STDs." 😬

I recognize that it could be useful for a numbers game, but I'm going to say this is probably going to cause more problems than it's worth for anyone not lining their pockets. Repeatedly taking antibiotics when you do not need them unsurprisingly fucks up your gut biome for a good while, which can just be diarrhea and stuff but also has some weird links like depression. Anyone reading this needs to make sure they're eating well, btw. Look after you.

It also increases the risk of generating antibiotic-resistant versions of what you were hoping to treat. If you are diagnosed with having syphilis, you can be cured with 1-3 penicillin shots and you are good to go. Please do not create Super Gonorrhea for fear of spending a whole week with regular gonorrhea, I did not put it on my bingo card.

I can see their thinking, but I'm not a total fan of this article even being written, especially as a suggestion from the CDC, who should know better, and I would personally suggest using protection and not taking things you don't actually need like they're Flintstones vitamins.

[–] [email protected] 4 points 1 year ago (1 children)

You bring up some excellent points.

After reading the article, I don't necessarily think it is biased to assuming STDs are more prevalent in the gay, bi, and trans community, just that that is the population this particular group of researchers have done the most studies on. I know that the gay, bi, and trans community in the past had much less healthcare studies for various reasons, so it is a good thing IMO that this population is not overlooked in studies and healthcare issues that impact all persons regardless of sex, sexual activity, or sexual identity.

I completely agree with limiting unnecessary prescriptions to help prevent "superbugs" along with secondary effects on the individuals taking the medications.

I never liked the idea of doctors just throwing pills at people. I have family members who run to their doc or a local clinic every time they get a cold to get a "z-pack" without just trying to deal with it allowing their non-compromised immune system do it's job. I believe part of the problem is lack of education (or incorrect information from online sites) and lack of knowledge of appropriate facilities to address conditions. The emergency room is for emergencies... not boo boos or something you can see your doctor or a doctor at a clinic for. Anyway, I have gone off on a tangent.

Thanks for your contribution in this discussion.

[–] [email protected] 1 points 1 year ago* (last edited 1 year ago)

After reading the article, I don’t necessarily think it is biased to assuming STDs are more prevalent in the gay, bi, and trans community, just that that is the population this particular group of researchers have done the most studies on. I know that the gay, bi, and trans community in the past had much less healthcare studies for various reasons, so it is a good thing IMO that this population is not overlooked in studies and healthcare issues that impact all persons regardless of sex, sexual activity, or sexual identity.

For sure, it makes sense as a target. I hadn't bothered to look it up the first time and I'm a little shocked that the differing rate is so high among the two groups -- anywhere from 1.5x higher to eleven in comparison with cishet, depending on the STD. But really.....they could definitely have worded that better than they did and I'm certain anything that successfully treats LGBT patients is probably also fine for the rest of humanity. It didn't sound great. 😅

Might even be temporarily damaging your immune system, doing that. These are the people overrunning the healthcare system. I mean, you're correct. It's understandable that you'd want the problem to go away, especially in a society that heavily punishes sick days, and a lot of it is wanting a quick fix for a problem they don't really know much about and trust professionals to handle in a way that's medically appropriate. They did, after all, pass a 10+ year course for this kind of knowledge. Sadly, they are not only abusively overworked but surprisingly lax if they're actually prescribing antibiotics over a head cold.

I still get to sigh about it. Stunningly high rates or no, that the CDC decided this was the best course of action feels irresponsible. They just complained about overuse a few years ago.

I think I'm fortunate enough to have had several family members in the medical field because that behavior would drive me up the wall. Admittedly, I am having the opposite problem wherein I have to convince people that no, it's not fine, you probably shouldn't be walking around on a broken leg and if you are in active labor you can stop cleaning for a hot minute. These are both real things that really happened, and the result is that I can never tell whether I'm being overly tough about pain when I don't need to be, or just being a hypochondriac at the slightest thing.

[–] [email protected] 4 points 1 year ago

So, as a pharmacist, I can tell you that Tetracyclines (class of drug which includes Doxy, Minocycline, Tetracycline) have been used as prophylactic drugs for quite a long time, and not just for their anti-microbial activity.

Minocycline for example is used prophylactically for recurrent UTIs, suspected meningitis, and frequent SSSI by staph

Doxycycline has been used long term for Acne prevention, Malaria prophylaxis, and STI treatment and prophylaxis.

While I do worry about overuse of Antibiotics in general. It seems that tetracyclines as a class have been used quite frequently over the last 50+ years. I am sure that in small pockets of the LGBT+ populations (the scope of this indication, it seems) you may see some resistance that will need to be treated with other antibiotics, but I don't think that we will see much cross-over into the general public. Furthermore, it looks like their is a new class making its way to hospitals soon that can get around the resistance seen, but we will need more studies to further nail that down.