Doxycycline

Background

• Tetracycline antibiotic

Spectrum of Activity

• Can treat: Actinomyces, Bacillary angiomatosis, Bartonella henselae, Borrelia miyamotoi, Brucella melitensis, Burkholderia mallei, Chlamydia trachomatis, Cutibacterium acnes, Enterococcus, Francisella tularensis, Legionella, Leptospira, Lymphogranuloma venereum, Mycoplasma genitalium, Pelvic inflammatory disease, Plasmodium, Rickettsia, Rickettsia africae, Rickettsia akari, Rickettsia conorii, Rickettsia prowazekii, Rickettsia rickettsii, Rickettsia typhi, Rickettsioses, Rickettsioses, Southern tick-associated rash illness, Stenotrophomonas maltophilia, Tick-borne relapsing fever, Treponema pallidum pallidum, Yersinia enterocolitica, Yersinia pestis

Distribution

• Achieves only low concentrations in the urine, so generally not recommended for UTIs, though some debate about this1
• CSF concentration is 15-25% of serum, but with 200 mg twice daily dosing should be reliably above MIC for syphilis and Lyme disease23

Dosing

• Usual dosing 100 mg po BID

Safety

Adverse Effects

• Counsel on high risk of sun sensitivity and pill esophagitis

Pregnancy

• Generally avoid using in pregnant women and children less than 8 years of age due to bone and tooth staining
  • However, can often tolerate short courses up to 5 days without issue