This decision-aid can help you decide whether to use antibiotics after sex to reduce your risk of contracting syphilis and chlamydia. Consider taking this resource to your doctor’s appointment to help make a shared and informed decision about whether Doxy-PEP is right for you.
Doxy-PEP means taking an oral dose of an antibiotic called doxycycline within 72 hours (3 days) of having sex (oral, anal, or vaginal) to protect against syphilis and chlamydia. Doxycycline is a safe and common medication used to treat certain infections, control acne, and prevent malaria. It does not work against viral infections such as HIV or herpes.
Doxy-PEP is most likely to benefit people at higher risk of syphilis, such as gay, bisexual, and other men who have sex with men, and transgender women, especially with recent syphilis or multiple recent sexually transmissible infections (STIs). It may also benefit others who want to reduce their risk of STIs including people taking HIV pre-exposure prophylaxis (PrEP), and commercial sex workers after a condom break.
Doxy-PEP reduces the risk of syphilis (by 70-80%) and chlamydia (by 70-90%). Due to antibiotic resistance it is unlikely to be effective against gonorrhoea, so it is important to regularly test for STIs.
*For more safety information see Safety information about doxycycline.
Doxy-PEP is one approach among several for preventing STIs. An open conversation with your doctor can help determine if Doxy-PEP is suitable for you based on your specific needs.
Discuss with your doctor:
If you have any concerns about taking doxycycline or experience any adverse effects from this medicine, speak with your doctor or pharmacist. If you decide to take Doxy-PEP, it is recommended to visit your doctor after 3 to 6 months to assess if you need to keep using it.
Using antibiotics causes bacteria to develop resistance, making them less effective for treating infections. Antibiotic resistance is a problem throughout the world and is a major threat to human health. For STIs, this is an issue for gonorrhoea. Widespread use of Doxy-PEP may increase resistant gonorrhoea strains in the community. It is important to weigh these concerns against the benefits of Doxy-PEP, particularly in preventing the serious health complications associated with syphilis .
Please see example below.
Example: Sex on Friday, take dose by Monday
Doxy-PEP is primarily recommended for people at increased risk of syphilis but can be prescribed to anyone (without a specific contraindication) who wishes to reduce their risk of syphilis and chlamydia and understands the risks and benefits. The need for ongoing Doxy-PEP should be reviewed at least every 6-months.
Prescribe doxycycline 200mg orally as a single dose up to 72 hours after sex.
Most people should be provided with a private prescription for 28 tablets with sufficient repeats to last up to 6-months. For concession card holders and those eligible under the Closing The Gap – PBS Co-payment program, it may be more cost effective to provide a PBS prescription. Under the PBS General Schedule, this is limited to 7 tablets with 1 repeat. Contact Services Australia (132 290) for clarification about PBS listings or the prescribing process.
