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Doxycycline (Vibramycin)

Category:

  • Antibiotic

Description:

  • Tetracycline antibiotic

Indications:

  • Rickettsiae infections (Rocky Mtn spotted fever, typhus fever, Q fever, rickettsialpox and tick fevers)

  • Mycoplasma pneumoniae infections

  • Psittacosis and ornithosis

  • Lymphogranuloma venereum and granuloma inguinale

  • Borrelia recurrentis infections

  • Gram-negative infections (E. coli, Enterobacter aerogenes, Shigella species, Acinetobacter calcoaceticus, H. influenzae, Klebsiella species,H. ducreyi, Yersinia pestis, Francisella tularensis, Bartonella bacilliformis, Bacteroides species, Campylobacter fetus, V. cholerae, Brucella species)

  • Gram-positive infections (Streptococcus species, S. pyogenes, S. faecalis)

  • For infections were penicillin is the drug-of-choice but is contraindicated (N. gonorrhoeae, Treponema pallidum, T. pertenue, Listeria monocytogenes, Clostridium species, Bacillus anthracis, Fusobacterium fusiforme, Actinomyces species,  N. meningitidis)

  • Acute intestinal amebiasis

  • Uncomplicated gonococcal infections (N. gonorrhoeae, C. trachomatis, Ureaplasma urealyticum)

  • Lyme disease (Borrelia burgdorferi)

  • Traveler’s diarrhea (E.coli)

  • Rape victim prophylaxis

Contraindications:

  • None

Precautions:

  • Pregnancy category D

  • Do not use in last half of pregnancy up to 8 years old due to tooth discoloration

  • May cause photosensitivity reactions

  • Prolonged intraveneous (IV) administration may lead to thrombophlebitis, initiate oral therapy as soon as possible

  • Doses greater than 2 grams per day may lead to hepatic function impairment

Excreted in breast milk

  • May cause pseudotumor cerebri (benign intracranial hypertension with symptoms of headache and blurred vision)

  • Do not use after expiration date.  Degraded, expired tetracyclines are highly nephrotoxic.

  • May be taken with food or milk.

  • Take with a full glass of water and remain standing for at least 90 seconds and/or lay down for 60 minutes to decrease occurrence of esophageal ulcers.

  • Complete full course of therapy.

Adverse Reactions (Side Effects):

  • Anorexia, nausea, vomiting, diarrhea, epigastric distress, loose stools, sore throat

  • Esophageal ulcers

  • Fatty liver, hepatotoxicity, increased BUN levels

  • Urticaria

  • Local injection site pain

Dosage:

Administered orally (capsules and suspension) and by IV injection

  • Adults (Children >8 years old or >45kg):

    • Oral:

      • Mild/moderate infections: 100mg po qd

      • Severe infections: 100mg po bid

    • Parenteral (IV only): 100-200mg per day, in 1 to 2 infusions per day

  • Children (>8 years old and <45kg):

    • Oral: 4.4mg/kg/day in 2 equal doses on first day then 2.2mg/kg/day in 1-2 doses up to 4.4

    • Parenteral: 2.2-4.4mg/kg/day (average 12mg/kg/day) in 2 divided doses

  • Acute gonorrhea: 

    • 200mg initially and 100mg at bedtime on first day , then 100mg q12h for 3 days or one-site visit of 300mg initial, followed by 300mg in 1 hour

  • Primary and Secondary syphilis: 

    • 300mg/day in divided doses for at least 10 days

  • Traveler’s diarrhea prophylaxis: 

    • 100mg a day

  • Endometriosis, salpingitis, parametritis, peritonitis: 

    • 100mg IV bid, with cefoxitin 2 grams IV qid

  • Chlamydia trachomatis

    • 100mg bid for 7 days

  • Rape victim prophylaxis: 

    • 100mg bid for 7 days

 

 


The information contained here is an abbreviated summary. For more detailed and complete information, consult the manufacturer's product information sheets or standard textbooks

Source: Operational Medicine 2001,  Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300

This information is provided by The Brookside Associates.  The Brookside Associates, LLC. is a private organization, not affiliated with any governmental agency. The opinions presented here are those of the author and do not necessarily represent the opinions of the Brookside Associates or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. All material presented here is unclassified.

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