TINJAUAN LITERATUR : EFEKTIVITAS DOXYCYCLINE POST-EXPOSURE PROPHYLAXIS (DOXYPEP) SEBAGAI PENCEGAHAN SIFILIS DI TENGAH KEKHAWATIRAN RESISTENSI ANTIMIKROBA
DOI:
https://doi.org/10.31004/jkt.v6i4.50954Keywords:
DoxyPEP, Sifilis, Treponema pallidum, Doxycycline, Resistensi Antimikroba, Pencegahan IMSAbstract
Insidensi sifilis global yang meningkat menuntut strategi pencegahan yang lebih efektif. Salah satu pendekatan terbaru adalah Doxycycline Post-Exposure Prophylaxis (DoxyPEP), yaitu konsumsi doxycycline setelah hubungan seksual berisiko. Tinjauan ini bertujuan mengevaluasi efektivitas DoxyPEP dalam pencegahan sifilis dan menelaah implikasinya terhadap resistensi antimikroba (AMR). Literatur relevan diidentifikasi melalui PubMed/MEDLINE, PMC, serta pedoman dari CDC dan WHO, mencakup uji klinis acak terkontrol, studi observasional, dan surveilans molekuler. Hasil dari uji klinis utama (DoxyPEP, DOXYVAC, IPERGAY) menunjukkan bahwa penggunaan DoxyPEP mampu menurunkan insidensi sifilis lebih dari 70% pada laki-laki yang berhubungan seks dengan laki-laki dan wanita transpuan. Analisis mikrobiologis dan genomik mengonfirmasi bahwa Treponema pallidum tetap sangat rentan terhadap doxycycline, dengan tidak adanya bukti resistensi klinis yang relevan. Namun, kekhawatiran AMR terutama berkaitan dengan seleksi Neisseria gonorrhoeae yang resisten dan peningkatan gen resistensi tetrasiklin dalam mikrobioma usus. Oleh karena itu, meskipun DoxyPEP merupakan strategi pencegahan yang efektif dan layak bagi populasi berisiko tinggi, implementasinya harus dilakukan secara hati-hati. DoxyPEP perlu diintegrasikan ke dalam layanan kesehatan seksual komprehensif serta didukung oleh surveilans resistensi antimikroba yang kuat untuk memantau dampak jangka panjangnya.References
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