In addition to the general indications for all members of the tetracycline antibiotics group, doxycycline is frequently used to treat Lyme disease, chronic prostatitis, sinusitis, pelvic inflammatory disease, Moraxella catarrhalis, Brucella melitensis, Chlamydia pneumoniae, and Mycoplasma pneumoniae are generally susceptible to doxycycline, while some Haemophilus spp., Mycoplasma hominis, and Pseudomonas aeruginosa have developed resistance to varying degrees. Some Gram-positive bacteria have developed resistance to doxycycline. Up to 44% of Streptococcus pyogenes and up to 74% of S. faecalis specimens have developed resistance to the tetracycline group of antibiotics. When bacteriologic testing indicates appropriate susceptibility to the drug, doxycycline may be used to treat these infections caused by Gram-positive bacteria: The World Health Organization Guidelines states that the combination of doxycycline with either artesunate or quinine may be used for the treatment of uncomplicated malaria due to Plasmodium falciparum or following intravenous treatment of severe malaria. Doxycycline kills the symbiotic Wolbachia bacteria in the reproductive tracts of parasitic filarial nematodes, making the nematodes sterile, and thus reducing transmission of diseases such as onchocerciasis and elephantiasis. Doxycycline has been used successfully to treat sexually transmitted, respiratory, and ophthalmic infections. Tetracyclines Staphylococcus aureus, Streptococcus pneumonia, Streptococcus pyogenes, Streptooccus agalacticae, Campylobacter jejuni, Haemophilus influenzae, Neisseria gonorrhoeae, Neisseria meningitides, Clostridium spp., Peptostreptococcus spp., Peptococcus spp. Bacteroides melaninogenicus, Bacteroides fragilis Inhibits bacterial protein synthesis by binding with the 30S ribosomal subunit. Tetracyclines produce a combination of concentration and time-dependent killing (AUC: MIC ratio). Dose of 200mg PO: Cmax: 1.5-3.6 mcg/m L; Tmax: 1.5-4 hours; Half-life: 14-24 hours; Volume of distribution: 50 L/kg; Table 3 GI: epigastric burning, abdominal discomfort, nausea, vomiting, anorexia, diarrhea, esophagitis, esophageal ulcers, dysphagia, candidal superinfections Teeth and bone: (dose/duration related) yellow discoloration of teeth, which turns into a gray-brown permanent discoloration, hypoplasia of enamel, teeth demineralization, skeletal growth retardation Hepatotoxicity: rare, but fatal; intrahepatic cholestasis, jaundice, azotemia, acidosis, irreversible shock Renal Toxicity: hyperphosphatemia, acidosis, polyuria, polydipsia Photosensitivity and hyperpigmentation: red rash to blistering on sun-exposed areas; photoallergic reactions manifested by paresthesias of hands, feet, nose, photo-onycholysis Auditory: tinnitus, hearing loss Vision: visual disturbances CNS: lightheadedness, dizziness, ataxia, drowsiness, headache Oral: 20mg, 50mg, 100mg capsules 25mg/5m L suspension 50mg, 75mg, 100mg tablets IV: 100mg Solution for injection Lyme disease: 100-200 mg/day PO x 10-20 days Periodontitis: 20mg 20 mg PO q12h for up to 9 months Chlamydial infection: 100 mg PO q12h x 7 days Bacterial infectious disease, Susceptible infections due to Vibrio cholerae, Brucella species, Rickettsiae, Yersinia pestis, Francisella tularensis, M. pneumoniae: 100 mg PO q12h Table 4, Table 7 2.2-4.4 mg/kg/day in 1-2 divided doses Table 4, Table 7 Renal failure: None necessary Hepatic failure: No dosing changes recommended at this time. Precautions: Usage in newborns, infants, and children less than 8 years of age risk for tooth discoloration; Phototoxicity Warfarin: Increased anticoagulant effect Barbiturates, phenytoin, carbamazepine: Decreased serum concentrations of doxycycline Oral contraceptives: Decreased contraceptive effectiveness Ethanol: Decreased doxycyline serum concentrations Table 6 Category D: Risk established, but benefits may outweigh risk. Therapeutic: Culture and sensitivities, serum levels, signs and symptoms of infection, white blood cell count Hypersensitivity syndrome reaction, serum sickness like reaction or single organ dysfunction Monitor: CBC, LFTs, urinalysis, urea, creatinine, chest radiograph Drug-induced lupus: monitor antinuclear antibody and hepatic transaminases General long-term therapy: Liver and renal function tests, Hematopoietic studies ABADOX (Lafar - ITALY) ACNE-CY-CLEAN (Brovar - SOUTH AFRICA) ACTIDOX (Saninter - PORTUGAL) ADOXA (Bioglan - USA) AKNEFUG DOXY (Wolff - GERMANY) AK-RAMYCIN CAPSULE (AKORN - U. S.) ALIUDOX (Aliud - AUSTRIA) AMBRODOXY (Hexal- GERMANY) AMBROXOL AL COMP (Aliud - GERMANY) AMDOX-PUREN (Alpharma-Isis - GERMANY) AMERMYCIN - (Unison, Thai. Azithromycin Cytotec 200 mcg tablet The increasing incidence of bacterial resistance to tetracyclines has in turn resulted. 6-Deoxy-5-hydroxytetracycline, Doxycycline, Vibramycin, 1967, Marketed. Each capsule contains 100mg doxycycline base as doxycycline hyclate. strains of Gram-positive and Gram-negative bacteria and certain other micro- organisms. Due to the potential severity of the infection, a rapid-acting schizonticide. These results suggest that the antibiotic doxycycline has anti-inflammatory. toxin 1 TSST-1 and the structurally related exotoxins are bacterial exotoxins that. (IV) or V (PO) Spectrum: Many strains of Streptococci (Drug of choice for Group A Strep - universally PCN sensitive), minority of Staphylococci (most are resistant) and some Enterococcus, most oral anaerobes, Syphilis (universally PCN sensitive). Used for: Strep throat and other infections due to Group A Strep, Syphilis (for neurosyphilis or pregnant women, must desensitize to PCN), bacteremia/endocarditis due to PCN sensitive Streptococcus, Enterococcus, or Staph aureus ( (PO) Spectrum: some Gram positives (Strep, Enterococcus, Listeria) but NOT MSSA, and limited Gram negative coverage. Notable gram negative holes include Klebsiella, Moraxella, and SPICE A organisms. Used for: Upper respiratory infections, sinusitis, otitis media, cellulitis, Listeria infections, UTI’s, early Lyme disease (alternative to Doxycycline), and more. Used for: Drug of choice for MSSA infections (unless PCN sensitive, which is rare). Good choice for cellulitis, osteomyelitis, endocarditis, and bacteremia from MSSA. Usually combined with beta lactamase inhibitors (see below) which confers broader activity; however, beta-lactamase component does not add activity vs Pseudomonas (so if Pseudomonas is sensitive, could use Piperacillin alone). addition of beta lactamase inhibitor confers broader spectrum against common beta-lactamase producing organisms (such as MSSA, some gram negatives including H.influenza, Moraxella, and virtually all anaerobes). Doxycycline is a topic covered in the Johns Hopkins ABX Guide. To view the entire topic, please sign in or purchase a subscription. Official website of the Johns Hopkins Antibiotic (ABX), HIV, Diabetes, and Psychiatry Guides, powered by Unbound Medicine. Johns Hopkins Guide App for i OS, i Phone, i Pad, and Android included. Explore these free sample topics: Dzintars, Kathryn, and Paul A Pham. "Doxycycline." Johns Hopkins ABX Guide, The Johns Hopkins University, 2017. Available from: https:// TY - ELEC T1 - Doxycycline ID - 540178 A1 - Dzintars, Kathryn, Pharm. Doxycycline bacterial coverage Comparative Susceptibility of Anaerobic Bacteria to Minocycline., Doxycycline 100mg Capsules - Summary of Product Characteristics. Dosing for amoxicillinOrder viagra nowCialis results picturesZoloft bruising Oral options include Bactrim 2 DS tabs bid best or Doxycycline 100 mg po bid both have poor strep coverage so should be paired with one of the oral beta-lactams. Clindamycin is an option but CA-MRSA resistance can exceed 50%. ANTIBIOTICS REVIEW. Doxycycline Is Anti-Inflammatory and Inhibits Staphylococcal Exotoxin.. Doxycycline bacterial coverage - MedHelp. Doxycycline is a broad spectrum semisynthetic tetracyclines. is a bacteriostatic drug acts by binding reversibly to the 30S subunit of the bacterial ribosome. Legal/Policy Toolkit for Adoption and Implementation of Expedited Partner Therapy Doxycycline displays excellent activity against gram-positive and gram-negative aerobic and anaerobic pathogens. The oral absorption of doxycycline is rapid.