Doxy-PEP

（多喜事後丸）

• 什麼是Doxy-PEP？
  
  Doxy-PEP是使用 Doxycycline（多喜黴素）這種抗生素作為暴露後預防性投藥，預防細菌型性病，例如梅毒與披衣菌的感染。 這是一種預防性病的方式，但不是用來治療性病。
  
  

• 怎麼使用Doxy-PEP？
  
  使用的口訣是「3-2-1」，也就是在「暴露後（性行為後）三天內、同時服用100 mg doxycycline 兩顆、一次服用即可」。服用藥物時，建議搭配食物較少腸胃副作用，另外應避免跟牛奶一起服用影響吸收。多個大型臨床研究發現，使用Doxy-PEP可以有效減少8成左右梅毒與披衣菌的感染，但是對於淋病的預防並不全然有效，尤其是在淋病抗藥性較高的地區進行的研究結果顯示無法預防淋病。
  
  
  
  

• 使用Doxy-PEP的預防效果如何？
  
  多個大型臨床研究發現，使用Doxy-PEP可以有效減少8成左右梅毒與披衣菌的感染，但是對於淋病的預防並不全然有效，尤其是在淋病抗藥性較高的地區進行的研究結果顯示無法預防淋病。
  

• 使用Doxy-PEP應該做什麼檢查？
  
  建議每三個月回診抽血篩檢HIV與梅毒，以及每三到六個月使用PCR的方式篩檢淋病與披衣菌，即便是沒有症狀也應該定期篩檢。 目前在門診，我們會建議用同一隻採檢拭子，依順序自行採集咽喉深處、尿道前端、與肛門直腸的檢體，使用pooling PCR的方式每六個月自費篩檢一次，價格約為2000元左右。
  
  

• 自費購買Doxy-PEP的花費是多少？
  
  兩顆doxycycline的費用大概在3-5元左右。
  
  

• 如果檢查有問題該怎麼辦？
  
  無論是否有症狀，任何篩檢梅毒、淋病與披衣菌陽性的結果都應該停止繼續使用Doxy-PEP，儘速回到門診接受治療。治療的方式包括口服抗生素或是肌肉注射抗生素。
  
  單用Doxy-PEP並沒有辦法徹底治療梅毒、淋病與披衣菌，如果沒有接受完整治療，有可能會引發細菌的抗藥性，增加未來治療的困難。
  
  
• 誰應該考慮使用Doxy-PEP？
  
  目前國內並無臨床指引建議優先使用Doxy-PEP的族群。依據澳洲與美國的指引，如果過去曾反覆感染梅毒或是其他性病，或是之後有持續暴露感染性病風險的人，可以考慮使用Doxy-PEP來減少感染梅毒與披衣菌。
  

• What is Doxy-PEP?
  
  Doxy-PEP is an antibiotic, named doxycycline, for post-exposure prophylaxis to prevent bacterial sexually transmitted infections such as syphilis and chlamydia. It's a preventive measure but not a treatment for STIs.
  
  
• How to take Doxy-PEP?
  
  The mnemonic is "3-2-1", meaning 3 days after exposure, take 2 capsules of 100 mg doxycycline, all at once. It's recommended to take it with food to reduce gastrointestinal side effects and avoid taking it with milk to ensure proper absorption.
  
  
  
  
  
• What is the preventive effect of Doxy-PEP?
  
  Several large clinical studies have found that Doxy-PEP can effectively reduce around 80% of syphilis and chlamydia infections, but it's not entirely effective for preventing gonorrhea, especially in areas with high antibiotic resistance to gonorrhea.
  
  
• What check-ups should be done when taking Doxy-PEP?
  
  It's advised to return for check-ups every 3 months for HIV and syphilis blood tests, and every 3 to 6 months for gonorrhea and chlamydia tests using PCR, even without symptoms. Sampling is done sequentially from the throat, urethra, and rectum, using pooling PCR every six months at a cost of around 2,000 NT dollars.
  
  
• How much does it cost to purchase Doxy-PEP at one's expense?
  
  The cost of 2 doxycycline pills is approximately 3-5 NT dollars.
  
  
• What to do if there are issues with the tests?
  
  Regardless of symptoms, anyone with positive results for syphilis, gonorrhea, or chlamydia should stop using Doxy-PEP and seek medical treatment promptly. The treatment may include oral or intramuscular antibiotics.
  
  Doxy-PEP alone cannot fully treat these infections, and an incomplete treatment may lead to antibiotic resistance, making future treatment more difficult.
  
  
• Who should consider taking Doxy-PEP?
  
  Currently, there are no clinical guidelines recommending the prioritized use of Doxy-PEP in Taiwan.
  According to Australian and American guidelines, individuals who have had repeated syphilis or other STI infections in the past or who are at continued risk of STI exposure may consider taking Doxy-PEP to reduce the risk of syphilis and chlamydia infection.
  

延伸閱讀：

• 其他性病（STDs）預防、診斷、治療資訊可參考本會網站：其他性病 (Other STDs)。
  
  
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