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Intrapleural Fibrinolytics Empyema — SCE Infectious Diseases MCQ

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HardRespiratory InfectionIntrapleural Fibrinolytics EmpyemaSCE Infectious Diseases

A cisgender gay man has had rectal chlamydia and early syphilis in the previous 12 months despite regular screening and condom counselling. Following shared decision-making, doxyPEP is selected. Which instruction matches BASHH 2025?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Doxycycline 200 mg after sex, preferably within 24 hours and no later than 72 hours, maximum once daily

Explanation lettering: B = shown as A · D = shown as B · E = shown as D · A = shown as E

C is correct. BASHH uses a single 200 mg post-exposure dose, preferably within 24 hours, no later than 72 hours and no more than once in 24 hours for selected people at high STI risk. A turns event-driven prophylaxis into continuous therapy. B gives pre-exposure and excess dosing. D makes treatment depend on known gonorrhoea exposure despite limited gonococcal benefit. E invents a multi-day course.

Reference: BASHH UK doxycycline post-exposure prophylaxis guideline 2025: https://www.bashh.org/_userfiles/pages/files/guideline_doxypep_final_9thjune2025_v11.pdf