Doxycycline / Vibramycin

- See: Tetracycline

- Discussion:
    - broad spectrum antibiotic, for rickettsiae, chlamydia, mycoplasma pneumoniae, bacteroides, useful for chronic bronchitis,
             & prostatitis;
    - tetracycline of choice w/ renal impairment; long acting;
    - adult: 100mg PO q12hr/day #1, then, 100mg/day or 50mg/day PO bid or 100-200mg/day IV qd; 
    - peds: > 8yrs: 5 mg/kg/day PO or IV, divided q 12hr; Contraindicated in pregnancy and in children < 8yrs;
    - supplied: tabs: 50mg, 100mg; caps: 50mg, 100mg; powder for injection 100mg, 200mg per vial;
    - take with food to avoid nausea;

- Hazards:
    - photosensitivity;
    - absorption will be decreased by aluminum, iron, bismuth, and Mg salts;
    - half life decreased by barbituates, phenytoin, and tegertol, and bicarbonate will decrease absorption and incr clearance
            of doxyclcline;
    - digoxin will increase serum levels; 
    - renal failure; 60mg PO qid;;
    - ratio of CSF to blood level (%): normal meninges: 13;
    - inflammed meninges: 18; dosing regimens for patients with renal
    - insufficiency (dose for 70kg adult {gm/dosing interval in hours}):
           CrCl >80: 0.1/12; CrCl 50-79; 0.1/12; CrCl: 30-49; 0.1/12; CrCl:10-29: 0.1/12;
           - 40 % of dose will be excreted in urine (w/ nl R F(x)) over 72 hrs

- role of Doxycycline in tendon repair:
      - nonspecific inhibition of MMPs using doxycycline protected the muscle from reperfusion injury
      - Doxycycline-Mediated Inhibition of Matrix Metalloproteinases Improves Healing After Rotator Cuff Repair

Images in clinical medicine. Minocycline-induced hyperpigmentation.

Intra-articular administration of doxycycline in calves.

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Monday, April 24, 2017 5:52 am