KEY POINTS
- Doxycycline (Doryx) is a tetracycline antibiotic that inhibits bacterial protein synthesis through binding with the 30S ribosomal subunit
- Has activity versus many organisms, including community-acquired methicillin-resistant Staphylococcus aureus, Chlamydia trachomatis, Borrelia burgdorferi (the cause of lyme disease), Plasmodium sp. (the cause of malaria), and Treponema pallidum (the cause of syphilis), Bacillus anthracis (the cause of anthrax), Rickettsia rickettsii (causes rock mountain spotted fever)
- Historically has been promoted that it should not be used in persons less than 8 years of age due to potential tooth enamel hypoplasia or permanent tooth discoloration – HOWEVER, more recent data endorsed by CDC has shown doxycycline is safe for patients less than 8 years of age
- Pregnancy category D – should generally be avoided in pregnancy
- Beware phototoxicity, esophagitis and nausea
- Available oral and injectable
- There are a variety of oral formulations available
- 100mg twice daily is a common dose and frequency
- Can be used as a sclerosing agent
- No adjustment needed in dose or frequency for kidney or liver dysfunction
RESOURCES
- Doxycycline Oral Package Insert
- Doxycycline Injection Package Insert
- 2015 CDC STD Guideline
- Surgical Prophylaxis Guidelines
- Research on doxycycline and tooth staining
- IDSA Lyme Disease Guideline
- IDSA Skin And Soft Tissue Infection Guideline
- IDSA Community Acquired Pneumonia Guideline
- IDSA MRSA Guideline
- CDC Malaria Page
- CDC Anthrax Page
- CDC Tularemia Page
- CDC Tickborne Rickettsial Disease Guideline