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Correspondence
Clostridioides difficile infection following self-directed post-exposure antibiotic use for STI prevention
  1. Angelo Roberto Raccagni1,
  2. Flavia Passini1,
  3. Elena Bruzzesi1,
  4. Flavia Badalucco Ciotta1,
  5. Simona Bossolasco2,
  6. Antonella Castagna1,2,
  7. Silvia Nozza1,2
  1. 1Vita-Salute San Raffaele University, Milan, Italy
  2. 2IRCCS San Raffaele Scientific Institute, Milan, Italy
  1. Correspondence to Dr Angelo Roberto Raccagni; raccagni.angelo{at}hsr.it

https://doi.org/10.1136/sextrans-2025-056479

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    A man who has sex with men, living with HIV and having a history of previous syphilis, presented to our outpatient STI service with gastrointestinal symptoms following use of multiple antibiotics intended as postexposure prophylaxis (PEP) for STI prevention.1 2 He was receiving antiretroviral treatment with intramuscular cabotegravir and rilpivirine long-acting, with stable HIV RNA suppression (<50 copies/mL) and a high CD4 count (>1000 cells/µL). He reported engaging in condomless receptive and insertive oro-anal sex with >100 partners in the previous week and taking different antibiotics for STI PEP, but deviating from the recommended use and dosing schedule. These included doxycycline (200 mg two times per day daily for three consecutive …

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    Footnotes

    • Handling editor Anna Maria Geretti

    • Contributors ARR visited the individuals and contributed to the writing of the article. FP contributed to the writing of the article. EB contributed to literature review and the revision of the article. FB and SB visited the individual. AC and SN coordinated clinical activities and contributed to the revision of the manuscript. All authors have read and agreed to the published version of the manuscript. All authors had direct access and verified the underlying data reported in the manuscript. All authors had full access to all the data in the study and accept responsibility to submit for publication. ChatGPT for improvement of written English.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.