[Question #13345] risk exposure questions
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3 days ago
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- If using doxy post the usual dosage is 200mg taken at once w/in 72 hours. But why isn’t it just a short course, like 3-4 days 100mg 2x per day? Wouldn’t that be enough to stop incubating syph & clam at least? (realizing gon is more complicated to treat)
- If doxy is started immediately post exposure, and if there was incubation of syph or clam, does it ever become contagious or does it arrest and prevent spread? I guess I’m trying to understand taking 1-3 days of doxy vs the recommended 14 days for established syph, or 7 days for est. clam.
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Edward W. Hook M.D.
3 days ago
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Welcome back to the Forum. The reason that doxycycline post exposure prophylaxis is that immediately following an exposure it is easier to prevent an infection from taking hold than it is to treat an established infection where there are more bacteria present. The recommended doses are the ones that were proven to be effective in large, well conducted studies. Once established, different infections require different durations of therapy because of differences in the biology of the organisms that cause them, I.e. factors such as susceptibility to antibiotics and how rapidly the bacteria grow. EWH ---
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3 days ago
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Thank you for your response Dr. Hook. Since doxy post is a single 200mg dosage, and it is ~70% effective for syph and clam, and ~50% effective for gon, would those percentages increase (at least for clam and syph) if someone continued doxy (100mg 2x per day) for a few days afterwards? It wouldn’t be as much as the full dosages for est. infections but the potential infections would be in an early stages, so couldn’t it be easier to treat/prevent this way?
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Edward W. Hook M.D.
3 days ago
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I'm not sure where you are getting your data. Doxy PEP is more than 90% effective for syphilis and chlamydia prevention, perhaps substantially more effective when taken as recommended. The 50% figure for gonorrhea is correct and is that low because about help of gonorrhea is resistant to doxycycline and would not be prevented with higher doses. Higher doses are unlikely to be more effective.
One follow-up remaining. EH
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2 days ago
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- Would someone who uses doxy post ever actually have been able to spread infection?
- Because gon is 50%, I remember in a past question you mentioned that if the head of penis is covered with condom, that it is good protection against gon and chlam. What is the general percentages of protection a condom provides to penis inserted into an infected cavity for gon/chlam/syph? I apologize if I got off topic, but I am grateful for how informative all of this is.
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Edward W. Hook M.D.
2 days ago
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As you know, we provide up to 3 responses to each client's question. There will be no need for further questions. It's time for you to move on- Doxy PEP is highly effective as are condoms. I hope you will work to practice safe sexual practices with your casual partners. To do so will substantially reduce your risk for STIs.
1. Person's who take doxy-PEP might transmit infection if they are already infected. They cannot transmit an infection they do not have.
2. Condoms, when used throughout a sexual encounter provide virtually complete protection from infection with gonorrhea and chlamydia and provide major protection against risk for syphilis
End of thread. EWH.
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