Doxycycline

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General

  • Type: Tetracyclines
  • Dosage Forms: PO and IV (20 mg, 50 mg, 75 mg, 100 mg, 150 mg, 25mg/5 mL)
  • Common Trade Names: Adoxa, Avidoxy, Doryx, Monodox, Oracea, Periostat, Vibramycin

Adult Dosing

General Infections

  • 100 mg PO/IV qd or q12h depending on severity
    • Variable duration

Severe Acne Vulgaris

  • 100 mg PO qd
    • Start 100 mg PO q12h x 1 day

Periodontitis

  • 20 mg PO q12h

Acute Bacterial Sinusitis

  • 200 mg/day PO q12-24h x 5-7 days

Chlamydia

  • 100 mg PO q12h x 7 days
  • Treatment and prophylaxis for sexual assault victims

Gonorrhea

  • 100 mg PO q12h x 7 days
  • Not first line- use with ceftriaxone

PID

  • Outpatient
    • 100 mg PO q12h x 14 days
  • Inpatient
    • 100 mg IV q12h x 14 days
    • Switch to PO when able and complete course

Cervicitis

  • 100 mg PO q12h x 7 days

Syphilis

If hypersensitivity to Penicillin

Primary/Secondary/Latent<1 year

  • 100 mg PO q12h x 14 days

Latent >1 year/unknown

  • 100 mg PO q12h x 28 days

Lymphogranuloma Venereum

  • 100 mg PO q12h x 21 days

Urethritis

  • 100 mg PO q12h x 7 days

Epididymitis

  • 100 mg PO q12h x 10 days

Proctitis

  • 100 mg PO q12h x 7 days

Lyme Disease

  • 100 mg PO q12h x14-21 days
  • Treat for 28 days if Lyme arthritis

Anthrax

First line agent in pregnancy

Inhalational, GI, Oropharyngeal

  • 100 mg PO q12h x 60 days

Cutaneous

  • 100 mg PO q12h x 7-10 days
  • 60 day regimen if bioterrorism suspected

Post exposure prophylaxis

  • 100 mg PO qd x 60 days or until anthrax exposure excluded

Malaria prophylaxis

  • 100 mg PO qd
    • Start 1-2 days prior to exposure
    • Continue 4 weeks after exposure

Pediatric Dosing

Special Populations

  • Pregnancy:
  • Lactation:
  • Renal Dosing
    • Adult
    • Pediatric
  • Hepatic Dosing
    • Adult
    • Pediatric

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life:
  • Metabolism:
  • Excretion:
  • Mechanism of Action:

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G I
Strep. Pneumoniae S
Viridans strep X1
Strep. anginosus gp X1
Enterococcus faecalis R
Enterococcus faecium R
MSSA I
MRSA I
CA-MRSA S
Staph. Epidermidis R
C. jeikeium R
L. monocytogenes S
Gram Negatives N. gonorrhoeae I
N. meningitidis S
Moraxella catarrhalis S
H. influenzae S
E. coli S
Klebsiella sp I
E. coli/Klebsiella ESBL+ I
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg R
Enterobacter sp, AmpC pos R
Serratia sp X1
Serratia marcescens R
Salmonella sp I
Shigella sp I
Proteus mirabilis X1
Proteus vulgaris R
Providencia sp. X1
Morganella sp. X1
Citrobacter freundii X1
Citrobacter diversus X1
Citrobacter sp. X1
Aeromonas sp X1
Acinetobacter sp. R
Pseudomonas aeruginosa R
Burkholderia cepacia R
Stenotrophomonas maltophilia X2
Yersinia enterocolitica R
Francisella tularensis S
Brucella sp. S
Legionella sp. X2
Pasteurella multocida X1
Haemophilus ducreyi R
Vibrio vulnificus S+'
Misc Chlamydophila sp S
Mycoplasm pneumoniae S
Rickettsia sp S
Mycobacterium avium R
Anaerobes Actinomyces S
Bacteroides fragilis I
Prevotella melaninogenica S
Clostridium difficile X1
Clostridium (not difficile) S
Fusobacterium necrophorum X1
Peptostreptococcus sp. S

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

Source

  1. Sanford Guide to Antimicrobial Therapy 2014