Tetracycline-resistant Neisseria gonorrhoeae global estimates - Impacts on doxycycline post-exposure prophylaxis implementation and monitoring: A systematic review

Abstract

Objectives Doxycycline post-exposure prophylaxis (doxyPEP) can reduce incident sexually transmitted infections including gonorrhoea for MSM and transgender women. Its effectiveness depends on the level of tetracycline resistance in Neisseria gonorrhoeae, which varies by country. Countries implementing doxyPEP should have robust antimicrobial resistance (AMR) surveillance using standardized, quality-assured methods. This systematic review estimates the proportion of tetracycline-resistant N. gonorrhoeae isolates by country/region and describes the contribution of sex and infection site to these estimates. Methods We searched bibliographic databases (1 January 2000 to 26 August 2024) for Engli..