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New Developments in STI Prevention and Treatment

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Sexually transmitted infection (STI) management continues to evolve, with new treatment options, prevention strategies, and practice considerations that are important for pharmacists to understand. This course reviews recent updates in STI care, including newly approved oral therapies for gonorrhea and doxycycline post-exposure prophylaxis. You will be better prepared to recognize practice-relevant changes and support evidence-based STI prevention, treatment, and patient counseling.



HOST
Rachel Maynard, PharmD
GameChangers Podcast Host and Lead, Clinical & Partnership Education, CEimpact

GUEST
Francisco Franco, PharmD, MS, AAHIVP
Registered Store Manager,
Walgreens



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 CPE INFORMATION
Learning Objectives
Upon successful completion of this knowledge-based activity, participants should be able to:
1. Describe recent updates in STI treatment and prevention that are relevant to pharmacy practice.
2. Compare emerging strategies for managing gonorrhea and STI post-exposure prophylaxis.

Rachel Maynard and Francisco Franco have no relevant financial relationships to disclose.

0.075 CEU/0.75 Hr
UAN: 0107-0000-26-241-H01-P
Initial release date: 6/22/2026
Expiration date: 6/22/2027
Additional CPE details can be found here.

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CE Credit And Show Purpose

SPEAKER_01

Here on Game Changers, we're all about helping you stay ahead of pharmacy practice. But why stop at listening? You can earn CE credit for this episode and hundreds more by visiting CEimpact.com and logging into your account or creating a new one. Get credit, get inspired, and make your learning count. Hey, CE Impact subscribers. Welcome to the Game Changers Clinical Update Podcast. I'm your host, Rachel Maynard. Today we'll be looking at recent changes in the prevention and treatment of sexually transmitted infections or STIs. And I'm really excited about this topic. There's been a bunch of potentially practice-changing updates in the last year or so that we need to know about as pharmacists. And specifically, we'll be looking at two new oral medications for treating gonorrhea. We'll also discuss how there's more awareness about the use of doxycycline post-exposure prophylaxis to prevent certain STIs after sex, also called doxypep, and a change in thinking for managing partners of patients with recurrent bacterial vaginosis. So lots of big changes we'll be looking at. And to help us navigate those changes and understand how they'll impact our practice, I'm very excited to welcome Dr. Francisco Franco to the part uh the program today. So welcome, Francisco. So happy to have you.

SPEAKER_00

Thank you so much, Rachel, for the invitation. Very happy to be here.

What STI Updates We Cover

SPEAKER_01

All right. Well, very good. And I know you have some unique background and some expertise to bring to this discussion. So if you wouldn't mind just sharing a little bit about your background, where you currently are and uh why you're passionate about this topic.

SPEAKER_00

So I am a registered store manager for Walgreens Specialty in St. Louis. And the site that I'm at is a unique site we are inside a doctor's office. And these doctor's office that we collaborate with primarily serve the LGBTQIA plus community. So most of our patients that are seen at the clinic are also seen by us at the pharmacy. We provide a lot of HIV care for both treatment and prevention. And we also work with our sexually expensive uh patients. So we provide a lot of uh gender or feminine care, hormone replacement therapy, and things of that nature. So it's it's a passion of mine. Uh I love these, I love working in my community and serving the people uh in my community, and that's what we do every day.

SPEAKER_01

That's fantastic. So I'm very excited to hear. I I'm sure you you're you like jumped on this topic when you saw it and you were like, this is right up my alley. So yeah.

SPEAKER_00

Yeah, our bread and butter. We talked about this almost every day.

SPEAKER_01

Excellent. Well, very excited to hear your perspective on this. Um, and I I, you know, I mentioned a few of these key changes. We sort of had these three topics that we wanted to talk about. And with all of these, you know, thinking about where we sort of have been and and maybe where we're going and what we need to know and and implement in practice. So let's

Francisco’s LGBTQIA Plus Care Lens

SPEAKER_01

start with those new treatments for gonorrhea. And can you give us an overview about what these oral options are, what they are going to bring to the table, how they work, if they, you know, any particular considerations we need to be thinking about in terms of placement therapy for these?

SPEAKER_00

So these new oral agents that we have, uh, it's uh one is named Soliflodacine and the other one gepotodacine. There are new oral options for the treatment of gonorrhea, while prior, the only treatment available was just an intramuscular injection.

SPEAKER_01

Um septriaxon, right?

SPEAKER_00

The septriaxon injection, right? So what we're looking at is what these new options are looking at is options for people that may not be have the access to get an immediate intramuscular injection right away, or if they have any kind of natal phobia, or perhaps um they don't they're not nearby any healthcare system or any uh, for example, if they're doing a telehealth visit, how they're gonna get treatment right away. So an or option actually becomes very prominent and prevalent in those areas. For solid deflacine is a it basically disrupts um bacterial DNA synthesis and typotodacino the same way. They have similar mechanisms of actions. While the chemical structures are different, uh they're considered novel mechanism novel agents for the treatment of um bacteria uh gonorrhea.

SPEAKER_01

They both I think they're both first in class, right? Like they're first in their class, and and and I think just to touch on that a little bit more, I think that's an important consideration. It's sort of got some headlines simply because of the resistance rates that we're seeing with traditional gonorrhea treatments. So I think that's gotten some attention for that reason.

SPEAKER_00

Because of the yeah, the long-standing treatment of Soft Trax and how these new molecules actually work, they've actually been able to cross that resistance that we have uh observed. Uh these agents, uh, while they're um oral agents, uh they're easy to use for most people that may not have any kind of like swallowing issues. Uh, the benefit with solifluidine is that it's a single dose. It's a packet that comes in a three-gram dose. So you create a suspension and you drink it uh with about four to eight ounces of water. It is indicated for adults um 12 years and older, and that weight at least 35 kilograms. For gepotodacine, uh, it's also an oral agent.

Two New Oral Gonorrhea Options

SPEAKER_00

You do it as two different doses. You do three grams now, and then 12 hours later, you will do another dose. There is a limitation in terms of weight. You need to weigh at least 45 kilograms in order to be able to qualify for gepotodazine, but also indicated for adults or people over the age of 12 years old.

SPEAKER_01

Okay. Okay. So it is nice to have these oral options, as you said, because there can be various reasons why the injectable subtraxone is not available or not desired by a patient, perhaps. Um, so the oral options are nice. And it's also nice that it's either one dose for the um zoophlodacin or the two doses 12 hours apart for the uh Jepidodacin. We're both practicing those names, getting used to them as we're having these new drugs. But yeah, so I think I think those are good things to be aware of. And again, um, with the increasing concerns around resistance with gonorrhea, I think there's a lot, been a lot of interest in trying to develop and get new antibiotics approved for to just expand the treatment options. So one thing with the zoolofacin that I noticed is uh some of these pregnancy considerations, concerns, uh, so not to be used in pregnancy, that uh if you can get a partner pregnant, you need to use effective contraception. And maybe you can speak to that.

SPEAKER_00

I see you uh Yeah, definitely. Um definitely watch out for uh persons that have a capacity of getting pregnant uh and not to be used for three to six months after treatment. So uh you would definitely have to use other secondary method of contraception for that time uh and during that time. If there is a risk of pregnancy, we can explore other options for the treatment of ganarrhea. Maybe we can just do the acetomycine one gram if needed be at that time. But uh these agents work really well. Other considerations to have is that for patients that may be taking uh C3 and four, moderate to like heavy inducers, uh, that may actually decrease the effectiveness of both of these medications.

SPEAKER_01

Okay.

SPEAKER_00

So something to also consider. And apart from the regular common side effects that you experience with most gamblantibiotics, uh just something um to just watch out.

SPEAKER_01

Mm-hmm. So, yeah, sort of not necessarily any unique side effects, common side effects that stand out, but being aware of these interactions as a concern with azolofloatus and the pregnancy considerations and using effective contraception, even though it's just that one dose for several months afterwards, is super important, I think. Yeah.

SPEAKER_00

Yeah. Uh another note is for jeepotodacine, according to the FDA indication, is for people that have limited or no other alternatives. So it's not going to be your first go-to option, uh, which also is going to limit um access in terms of insurance. Yeah. Because the cost of the medication is not that cheap, even with a good RX. It's still, you're still looking at several hundred dollars for that one treatment. So keeping in mind, if we need to go to solifodacin would probably be your go-to, and then depotacin would be your secondary option if solifodacin is not an option for that person.

SPEAKER_01

Yeah, thank you for calling that out because it is interesting that the labeling does specify for the chepatidasin. That's an only sort of a last resort option when other treatments are available. So important to call that out. Now, you did also bring up the important consideration of cost. I'm curious if you've seen these in your practice already and if access and cost is a barrier that you're running into, because certainly this is something we want treated quickly, effectively, and uh we don't want any delays in treatment. So, how has that been seen working out?

SPEAKER_00

Uh I haven't seen gypotodacine yet. Uh, we had a patient that we tried to get solifodasin covered, and after a priauthorization attempt, it just didn't go anywhere. So, and they were very hesitant to get the intramuscular injection.

SPEAKER_02

Okay. Yeah.

SPEAKER_00

So we went with an alternate method of using acidomycin, knowing that that may have not covered for the full instance at that time. And we just had the patient come back uh within a week to get them retested and then identify if we needed to like retreat again.

SPEAKER_02

Yep.

SPEAKER_00

But Solifodasine, yeah. I haven't seen Jibutodasine yet, but solifodasine, at least for this one time that we tried to get it covered, did not work.

SPEAKER_01

Got it. Okay. Well, that's good perspective to know. Real world experience there.

SPEAKER_00

It is, it is. You know, there are a couple of options, uh, but it is it is available. You can order it right away. But you know, costs and what insurance may cover may be a barrier for some people.

SPEAKER_01

Yeah, yeah. Okay. So, and the other thing, just to mention quickly about the Jeopathed ASIN, I think we might have talked about that on a prior podcast. It's also approved for uncomplicated UTIs in certain patients as well. So this gonorrhea approval was a later indication. So if you you may see it for other other uses too. And I just wanted to mention that. Um, so would you say that these two new oral options, uh you laid out very clearly that the jepidodacin is specifically for sort of a last resort, last line when other options are available? We talked about a little bit broader

Dosing Safety Pregnancy And Interactions

SPEAKER_01

role for the zolotoflace, zoladoflace. You know what I mean? Um, and so would you say that either of these are replacing the current standard of care, which is that injectable ceftriaxone, or would is that sort of your still go-to for most patients?

SPEAKER_00

I think the big takeaway from here would be that ceftriaxone still remains as a treatment of choice for gonorrhea, uncomplicated gonorrhea treatments. Um, but you know, now we have these two other options. We give just a little bit of something, a wiggle room for us to play. The dosing is going to be different. We just have to look at safety considerations and access. But it's going to be our goal stand gold standard for this kind of stuff.

SPEAKER_01

Contraction is still going to be the gold standard. Yeah. Okay. Good bottom line summary there. And I think it'll be interesting to see too, because again, over the past couple of decades, the resistance concerns with Oneoria have sort of grown and continued to be a concern. And so treatment recommendations have changed over time. So even though these are new options, it will be also important to see how those resistance concerns come into play with these as well.

SPEAKER_00

Absolutely.

SPEAKER_01

All right. Well, very good. Nice summary there. Let's move on to that second topic of doxypep. So the idea of having patients use this post-exposure prophylaxis with doxycycline after sex. And it's only for specific groups of patients and in specific scenarios. So maybe you can just get us all up to speed on what this doxypep option is.

SPEAKER_00

So doxypep stands for doxycycline, post-exposure prophylaxis. And it's uh intended to be taken uh within 72 hours after unprotected sex with the hope to reduce bacterial SCI, so sexual transmitting infections, mostly looking at syphilis and chlamydia. And in some instances, it may cover gonorrhea about 50% of the time. According to the CDC recommendations, uh people that are identified as gay, bisexual, or men there who have sex with men and transgender women that have had at least one STI in the previous 12 months should be offer um doxypep. And in my personal note, I would probably add that any sexually active uh person that have had at least an SCI in the previous 12 months should be considered for doxypep as well.

SPEAKER_01

Yeah, I so to clarify, that's the CDC recommendations, and there are guidelines from CDC about doxypep specifically. And as you said, they uh recommend at least having the discussion in men who have sex with men and transgender women. They have not gone beyond those populations yet, but I think that's simply due to lack of data. And so what I'm hearing you say is that you would consider having the conversation with other patients as well.

SPEAKER_00

And we do. Uh we have conversations with our patients, uh, this gender women, um heterosexual men that have had at least one SCI over the previous 12 months, we'll have that conversation of like what that looks like. And then perhaps looking at other options, even though it's not recommended by the CDC. I think for sexual health, it's important to have that conversation.

SPEAKER_01

Well, and for lots of reasons too, because that opens the door to a lot of

Cost Coverage And Access Reality

SPEAKER_01

other preventive discussions and screening and all of that, that you can sort of a yeah, go ahead.

SPEAKER_00

Yeah, no, exactly. You know, if uh the recommendation for like sample for HIV prep is that you haven't had at least one STI in the previous 12 months. So if we're gonna recover, if we're gonna be recommending Doxy PEP, we should also have that conversation for HIV prep as well.

SPEAKER_01

Yep, absolutely. And uh yeah, I was thinking about the relationship between Doxy Pep as an analogous sort of method to HIV PEP post-exposure prophylaxis, but that's a very different sort of situation. Yeah, you're absolutely right. Doxy PEP is a greater uh link to HIV prep pre-exposure prophylaxis and encouraging patients to take a preventive measure to prevent HIV transmission. So that's very good call out there. So tell us about how DoxyP works and how it's taken, what patients need to know about the actual regimen.

SPEAKER_00

So doxip is a dose as 200 milligrams that you take by mouth for one dose. Usually it suspends as two 100 milligram capsules. So it's two capsules, you take as one dose. You're gonna take it as soon as it's possible after you've had unprotected sex and no later than 72 hours. So that you have that 72 hour window after you've had either oral, uh, vaginal or anal sex.

SPEAKER_01

Okay. So again, that's where my mind was going with the HIV post-exposure prophylaxis because it's similar. You take it after, well, yeah, as soon as possible is when you need to start it, but it's longer duration, obviously. It's not that one dose like we're talking about with this doxypep. So this is one dose after unprotected sex. And my understanding is that it can be taken as often as needed after unprotected sex, as in uh it's not like one and done, you can have repeat doses post-exposure prophylaxis.

SPEAKER_00

You you could, you just don't want to take more than one dose um within 24 hours. So the map, the the minimum window between doses would be 24 hours. So if you've

Doxy PEP Who Should Consider It

SPEAKER_00

had unprotected sex today and then you have unprotected sex tomorrow, if it if it's been more than 24 hours since your last encounter, you can go ahead and take another dose.

SPEAKER_01

Okay, and ideally as soon as possible, but again, at least within 72 hours is when you'd want to take it.

SPEAKER_00

Absolutely.

SPEAKER_01

Okay. And you mentioned it is effective primarily for syphilis and chlamydia and mixed data on gonorrhea. So in again, thinking about other preventive measures here, I'm assuming a lot of your conversations are also around protected sex and and safer sex options like condoms and and what other strategies do you typically talk about with patients when you are working with them on this?

SPEAKER_00

We ask about what their uh basically their sexual activity looks like. Um, you know, do we have one partner? Do we have multiple partners? Do we know who our partners are and what their sexual activity looks like? So we're looking at protecting you, but also protecting your sexual partners as well. Um, and then we look at the previous history of things that may have been happening in the past. Uh, and we try to look at what things we can do to help you prevent recurrence. We also encourage uh CI testing uh every three or six months, depending on what your sexual activity or your sexual partners are, but also being aware that you know this is not gonna be a silver bullet that's gonna protect you from everything, right? So we uh it at times if we are unsure of what the situation is, using safe sex practices uh would be the best protection that we can ever have.

SPEAKER_01

Right. And I guess just to clarify, this doxype, is it is it only if there was an instance of unprotected sex or if if say condoms were used, that would still would a patient still consider it in that scenario, or is it really for if you're concerned about say a broken condom, for example?

SPEAKER_00

I for my patients that may be unsure of what may have happened during that encounter, yeah, sure. It's better to be safe than sorry later. Yeah. So uh if if there is any kind of doubt, just go ahead and um take your dose just to be safe in that instance.

SPEAKER_01

And so that's a good transition into some of the safety considerations too with this regimen. So, in terms of using it when needed and and as soon as possible after sex, unprotected sex, what are the safety considerations with those single dose options and and or if people are using it repeat times?

SPEAKER_00

So a couple of things to be aware of, just like um doxycycline is an antibiotic. So the GI upset, the vomiting, diarrhea, maybe a little bit of discomfort will potentially happen. The other thing to watch out with doxip is that doxycycline um causes photosensitivity. So, therefore, if we are in the summer times and we're out and about, we definitely have to use an extra layer of like sunscreen protection. And if it's the winter time and you're out on vacation on a tropical cool place, make sure that you bring your sunscreen because you're definitely going to be a little bit more sensitive to the sand during those times. You have to make sure that you drink your dose with at least a full glass of water so that medication actually gets in your stomach. And the other consideration is for people that take multivitamins because other these cations like calcium, iron, magnesium, and zinc can actually chelate to the doxy and actually make it less effective. So we want to make sure that we space those out about at least an hour.

How To Take Doxy PEP Safely

SPEAKER_01

And that is, I think, an important consideration because people may not think of this the same way as they would with an antibiotic that they might take for several days, for example, where you sort of get that routine education and you read the labeling and you see it interacts. But if you're just taking this as a one-off, especially as soon as possible after sex, then you might not be thinking about some of those considerations.

SPEAKER_00

100%. And we do emphasize that with our patients because for that same reason, antibiotic, you get used to the regimen for five to seven days, and you know, you can't do extern things with that one dose, then you know, you grab a piece of cheese or eat some yogurt later, right after, and you just kill your dose.

SPEAKER_01

Yeah, yeah, right, right. So, again, another good reminder for important, you know, education and administration points, but also that this is not a silver bullet, as you said, and that we still want to be ensuring other preventive measures are being taken, the screenings are being taken, that follow-up is being taken. Is there a recommendation around how uh how often to follow up with patients if they are getting this on a regular basis and what that looks like?

SPEAKER_00

We definitely um most of the patients that we see in our clinic, we make sure that they are coming back uh to clinic for STI testing every three to six months. Okay. Um, just to make sure that you know that we are covering all of our bases and there is treatment that needs to happen that we can go ahead and do that. We know that sometimes, and for some people, SDIs can go unnoticed for a while.

SPEAKER_02

Right, right.

SPEAKER_00

Some people don't show symptoms right away, and it could be a couple months before they can actually show symptoms. So being proactive with your sexual health is the best recommendation that we have for our patients.

SPEAKER_01

That's great and uh really good reinforcement there. And again, especially as people are coming back potentially for refills of the one one-time doses, uh having those conversations ongoing.

SPEAKER_00

Yeah. Yeah, we um since we do a lot of HIV prep in our clinic, a conversation that my technicians uh have been trained to in like my pharmacist is like if you know, when was the last time you actually got your doxipel? And then we look at their like refill history and be like, hey, are you good with it? Do you need a refill around at this time? So that way when you come and pick up your Will have your doxy available for you as at the same time. And the same for um the patients we do injectables uh in our clinic, um like uh uh Kabinuba and Apertuo, like these other injectables. And you know, we make sure that our patients also get their treatments whenever they come for their injections as well.

SPEAKER_01

Yeah, that's great in terms of being proactive and asking about it and letting it not fall off the radar just because maybe you haven't needed it in a while.

SPEAKER_00

In a while, absolutely. Yeah. It's something that we can get for you uh at your next visit right away.

SPEAKER_01

That's great. I love that product up approach. Okay, so very nice overview of Doxy Pep. I think we're up to speed on that one. And now let's move on to that third topic, which is about recurrent bacterial vaginosis and some new data that we have around treating partners of these patients with recurrent bacterial vaginosis. So I'll let you chat about that a little bit, get us up to speed there.

SPEAKER_00

So something that we have traditionally thought of bacterial vaginosis, it's what in what we call in medical terms, um, vaginal dysbiosis. So it's just thought that it's just the microbiome of the one individual that perhaps goes off at different times and that just leads to the overgrowth of bacteria, leading to the bacterial vaginosis. But there's been some epidemiological data from the CDC and um other labs that have shown that bacterial vaginosis associated bacteria has been found on sexual partners of someone that has had recurrent bacterial vaginosis, not only in male partners, but also in female sex partners, which was huge because then it showed that there is transmobility of the bacteria from one partner to another, which can potentially lead to that is where the recurrence is actually happening, right? So this is where all of these data started coming up, and there was a study that was published in 2025. Uh, the New England General of Medicine called it the step-up trial. And this is where they were looking, uh, they had uh two arms, one where they were just treating just the female partner, and then in the other one, they were treating the male partner with an antibiotic treatment. And they actually stopped the study early because the data and the safety monitoring was so good that they were like, no, listen, this is this is where we need to go, and we're gonna show this data. Uh so what they showed was that going doing the uh not only uh doing the partner treatment with an antibiotic by mouth, and then also a topic won't actually reduce the recurrence of bacterial vaginosis almost completely. Um, and that's just where that new recurrence data is coming up. So we know now that there are other options that we can use to treat bacterial vaginosis, not not only the female can get treated, if we actually treat the male partner or the female author partner, uh, we can actually prevent or stop the recurrence.

SPEAKER_01

Yeah, so I feel like this is potentially practice

Testing Follow Up And Refill Workflow

SPEAKER_01

changing in a couple of ways that the idea of treating the male partner or even female partner, as you said, treating the partner is something that has not historically been done. You know, we've seen that for other STIs where you might treat the partner if you, if one patient is diagnosed, the other partner might be treated. But this is something bacteriopaginosis has not historically been thought of as an STI. And so you, like you say, that there's that thinking is changing a little bit. And I think these data that New England Journal study is sort of raising that question too, because if we're seeing efficacy in treating the partner in reducing the risk of recurrence in the patient, that suggests that this, as you said, transmissibility is sort of a consideration that maybe wasn't well recognized before.

SPEAKER_00

Yeah, uh, I think it the part that we didn't know was that noticing that the bacterial vaginos associated bacteria was found in similar partners, especially the cases where uh monogamous female partners was the key for people to say, wait, hold on, there is re-inoculation happening here.

SPEAKER_02

Yeah, yeah.

SPEAKER_00

So we need to stop the reinoculation. We will definitely can stop the recurrence.

SPEAKER_01

Yeah, yeah. And I I saw a stat up to two-thirds of women patients have recurrence of bacterial vaginosis within a year of being treated. So it's a common problem. And that's why this is a big deal, because if we have an option to help prevent that recurrence, that could be game changing for some patients.

SPEAKER_00

For for a lot of people, and it's it will be a game changing on your day-to-day activities, not having to think about that. Oh, I'm gonna get, you know, it, you know, if people that uh perhaps are being less active or being less open about their sexual activity and their sexual life, you know, they may be um stopping themselves from actually having sexual encounters with their actual partner for the fear of getting a bacterial infection, right? So that can actually lead to problems in your actual relationship problems that uh that you know, if we can prevent all of that, then we may actually develop or prevent some of the other, you know, relationship issues that um that we that may add on stressors into relationships. And we know that relationships are difficult just by the nature of how they are. So eliminating eliminating some of the stressors can actually like help out some of these couples in general.

SPEAKER_01

Right, right. So when would you think about discussing this with your patients? Say they say you find out in one way or another they share with you, or you're seeing them get a treatment for bacterial vaginosis. When would you think about having this discussion around treating the partner potentially?

SPEAKER_00

Usually we have this conversation. If we've had two or more recurrence of um bacterial vaginosis within three months, that's that's kind of like for us at the clinic, that's kind of like what we look at. Is it the best method?

Recurrent BV And Treating Partners

SPEAKER_00

I don't know if it's the best method, we've never studied it. Uh, but this is like something that we just keep in mind. Like if we if we treated them like within three months for the same bacterial vaginosis, like, hey, let's talk, let's, let's, let's talk a little bit more about this, what's happening? You know, are we in a monogamous relationship? Do we have an open relationship? What's happening at home? You know, what what are your sexual practices? Maybe we can explore a little bit more about a variety of different things and then offer an option. Um, we do, I remember when this study came out, we were talking about in clinic, and some of our providers were like, like, oh my God, this is going to be a game changer because we've had these patients that come every every month, or they call us every month for another course of antibiotic, another course of antibiotic. And they were like, okay, we we have an option that we can use for some of our patients right now. And we've actually been using this for a little while for a couple of our patients and has definitely helped.

SPEAKER_01

That's great. That's very empowering to hear because it is something that is making a real difference in patients' lives, especially if they have struggled with this for maybe years and never had a good solution.

SPEAKER_00

Yeah. People that have just accepted the fact that this is what their life is, is very line-changing and you know, a game changer that, you know, you don't have to live with this every day. We have options that can actually help.

SPEAKER_01

Yeah, yeah, that's excellent. So I I and it's great to hear that you're already seeing this and seeing the benefits of this in practice. So it is it is a potentially practice-changing um uh set of evidence that we can now leverage those discussions with patients with. And, you know, I do want to talk about those conversations because it seems like you have a very good handle on how to have some of these difficult conversations with patients and open the door to that discussion. So, any advice for our listeners on best practices for helping set the stage and make the patient feel comfortable, ensuring that they have a safe space. What what are your what tips do you have around that?

SPEAKER_00

I usually start with, you know, how are we doing? Are we doing okay and how are we feeling today? And I will follow up with like, I noticed that this is uh that we've dispensed this medication for you, you know, a couple of times within the past few months. Tell me about, you know, how do you think this is coming along, right? Do you have any triggers? Have you noticed anything different? And then try to explore and then just like keep opening questions of like, okay, are we, you know, are we in a monogamous relationship? Do we have an open relationship? Do we know who our partners are? Do we have any concerns about any of our partners? And then following up is like, you know, we want to make sure that you get the adequate treatment. But if we can actually help you prevent you from this happening again, these are the options that we have. I mean, is this something that you may be interested in?

SPEAKER_01

Mm-hmm. Okay. Yeah, I think it's it's often just practice too, and and getting used to once patients respond, I'm sure you you've seen that it's just uh it's probably very rewarding for you, I would imagine.

SPEAKER_00

Yeah, some people get a little hesitant uh to when someone is asking about their sexual activity and their sexual partners. Uh, but in our clinic, it's something that we do on a daily basis. So it's routine, yeah. Yes, I I tell the patients like, listen, you know, uh, there's very few things you can tell me that are gonna shock me. So you can go ahead and tell me because I rather have all of the information that I need so I can actually provide you with the best answers that you can have.

SPEAKER_01

That's excellent. Again, it's it's putting putting the power in their hands.

Creating Comfort In Sexual Health Talks

SPEAKER_01

We're trying to help, and we just need the information to be able to do that properly.

SPEAKER_00

Absolutely. Absolutely.

SPEAKER_01

Yep. Well, to wrap up this topic, you know, we uh I you did a great summary of these three key areas and just thinking about how all of this is going to impact practice. And I know some of these changes aren't necessarily brand new, but some people may not be seeing too much of this yet. And we might continue to see traction being gained for doxip, for example, or the bacterial vaginosis and even these new gonorrhea treatments. So, where where do you think pharmacists play the biggest role with all of these changes and supporting patients and optimizing care?

SPEAKER_00

Um, so something that pharmacists need to remember is that we continue to be the most accessible healthcare professional there is. We are the ones that can actually have uh a lot more touch points with our patients and then utilizing these opportunities to capitalize on potential gaps in care that our patients may be experiencing. So if we have patients that we know that may be getting a prescription for an STI, we can look to make sure that they are actually, you know, getting the full treatment, uh, counseling them are the do's and don'ts when taking these medications, what to watch out for, and then addressing any other questions and concerns that they may have, and also to know when to refer, right? So it's always very important and uh something that we learn in pharmacy school is like you know, you create your differential and you know when to treat and when to when to refer, and providing that opportunity for them to actually see a provider that can actually have an opportunity for them. Um but for us to have the knowledge that you know the the treatments have changed, that we not only have the you know, the gold standard of the satraction for gonorrhea as intramuscular injection is still gonna be the preferred method, but patients, you know, they have other options right now, you know, we can use or options that we can have. Um, same thing for doctor that have other uh options to treat and prevent CIs. It's available now. And for our female patients that may have this recurrent of a bacterial infection that happens, they're not alone in this anymore. We can actually treat their partners or we can actually reduce the recurrence of that. But it just all happens with conversation and making sure that we have an open and honest conversation with our patients, and that we can give them the variety of options and then give the patient the autonomy and the self-determination for them to make a decision and empower them to make those decisions as well.

SPEAKER_01

That's an excellent bottom line. You summarized it so well, all these key changes. And as you said, I think having more options is always a good thing to have other sort of menu of options to be able to talk with patients about, but also just the fact that some of these are going to potentially improve accessibility, but also considering some of those cost concerns that might come up with some newer options, for example, but uh just empowering patients, as you said, with more ways to prevent and treat STIs when possible. And I think we can all be thinking about patients in our in our care that could benefit from some of these options and just being aware of them as potential considerations to be talking about.

SPEAKER_00

Absolutely. I think it's just giving the option to the patient to make an informed decision is the best that we can do for our patients.

SPEAKER_01

Absolutely. So the role of pharmacists continues to

Pharmacists’ Role And Key Takeaways

SPEAKER_01

evolve with these all these changes coming out. And so um really appreciate you summarizing this and bringing us, you know, up to the latest evidence and what we need to know about it in our practice. It is our game changers podcast. So we always wrap up with what the game changer is. And so, what would you say is the game changer you'd want our listeners to walk away with?

SPEAKER_00

That one size does not fit all. Uh, that we do have options for our patients and providing them with the most up-to-date information there is for them to actually make an informed decision uh is the best that we can do for our patients and continue to do on a daily basis for them.

SPEAKER_01

Fantastic. Thank you so much, Francisco. Your expertise and your personal perspective here was really empowering and educating. So thank you for the time.

SPEAKER_00

Thank you, Rachel, so much for the opportunity. I'm very happy and excited to be here with you guys.

SPEAKER_01

Fantastic. Thank you. Well, we talked about a lot of great practical tips today, and those will be summarized in the practice resource that goes along with this podcast on the CE Impact website. So feel free to access that and take it

Resources CE Credit And Sign Off

SPEAKER_01

along to remember some of the great things we talked about today, listeners. Otherwise, be sure to claim your CE credit for this episode of Game Changers by logging in at ceimpact.com. And as always, have a great week and keep learning. I can't wait to dig into another game changing topic with you all next week.