For older people and frail people, the long-term benefit of medicines reduces and the potential for harm from adverse effects increases. When the benefit–risk balance changes in this way, medicine review and optimisation are important to simplify the therapeutic regimen, reduce inappropriate medicines and minimise risks. In this article, pharmacist prescriber Linda Bryant uses two case studies to illustrate important considerations during medicine reviews
Screening and treatment of MSM on PrEP: Too much of a good thing?
Screening and treatment of MSM on PrEP: Too much of a good thing?

Sexual health specialist Massimo Giola discusses whether we are over-screening for sexually transmitted infections in certain populations and overusing antibiotics for asymptomatic positive cases
Kia ora and welcome to New Zealand Doctor Rata Aotearoa
Not a subscriber? Unlock this article by subscribing here.
1. Kenyon C, Baetselier I, Wouters K. Screening for STIs in PrEP cohorts results in high levels of antimicrobial consumption. Int J STD AIDS 2020;31(12):1215–18.
2. Traeger MW, Guy R, Asselin J, et al. Real-world trends in incidence of bacterial sexually transmissible infections among gay and bisexual men using HIV pre-exposure prophylaxis (PrEP) in Australia following nationwide PrEP implementation: an analysis of sentinel surveillance data. Lancet Infect Dis 2022;22(8):1231–41.
3. Coyer L, Prins M, Davidovich U, et al. Trends in sexual behavior and sexually transmitted infections after initiating human immunodeficiency virus pre-exposure prophylaxis in men who have sex with men from Amsterdam, the Netherlands: A longitudinal exposure-matched study. AIDS Patient Care STDS 2022;36(6):208–18.