Doxycycline

C difficile risk
Low
Oral Bioavailability
Excellent

Dosing

100 mg PO BID

General Information

  • Skin and soft tissue infection

  • Methicillin resistant staphylococcus aureus (MRSA) infections

  • Community acquired pneumonia

  • Malaria prophylaxis

  • Sexually transmitted infections

  • Pelvic inflammatory disease

Pregnancy:

  • Doxycycline itself is unlikely associated with an increased risk of congenital malformations, reduced fetal bone growth or teeth staining with in utero exposure, however, is usually avoided during pregnancy because of the associations of these adverse events with other tetracyclines (particularly in the second and third trimester).

  • Tetracyclines might induce hepatic necrosis in some pregnant women, however, this is a rare syndrome most commonly associated with intravenous dosing of tetracyclines.

Breastfeeding:

  • Doxycycline can be used during breastfeeding for short courses (ie. up to 3 weeks) as this has not been associated with infant dental staining.

  • Longer courses (ie. greater than 3 weeks) or repeat courses should be avoided as a precaution.

  • GI upset and erosive esophagitis

  • Photosensitivity rash

  • Tissue hyperpigmentation

  • Di- & Trivalent cations including Al, Ca, Fe, Mg (anatacids, dairy products, iron supplements, some enteral feeds) - decreases doxycycline absorption

  • Some anticonvulsants can decrease doxycycline levels

  • Increased digoxin levels

  • Increased INR with warfarin

May exacerbate muscle weakness in persons with myasthenia gravis

Antimicrobial class: Tetracycline