From the Guidelines
Doxycycline is recommended for the treatment of adult patients with early localized or early disseminated Lyme disease associated with erythema migrans, at a dose of 100 mg twice per day for 14 days, due to its effectiveness and the low frequency of serious adverse effects 1.
Key Points
- Doxycycline is a broad-spectrum antibiotic in the tetracycline class commonly used to treat various bacterial infections.
- It is typically prescribed at doses of 100mg once or twice daily for 7-14 days, depending on the condition being treated.
- Doxycycline effectively treats respiratory tract infections, urinary tract infections, certain sexually transmitted infections, acne, and is used for malaria prophylaxis (100mg daily).
- When taking doxycycline, it should be taken with a full glass of water, either with food or on an empty stomach, but not within 2 hours of taking antacids, calcium supplements, or iron products as these can reduce absorption.
- Common side effects include photosensitivity (increased sun sensitivity), nausea, diarrhea, and esophageal irritation.
- To minimize these effects, avoid direct sunlight, take the medication while upright, and stay upright for at least 30 minutes after taking it.
- Doxycycline works by inhibiting bacterial protein synthesis, preventing bacteria from growing and multiplying.
- It should not be used during pregnancy or in children under 8 years old as it can affect bone development and cause permanent tooth discoloration, as stated in the guidelines by the Infectious Diseases Society of America 1.
Special Considerations
- For children, amoxicillin, cefuroxime axetil, or doxycycline (if the patient is 8 years of age) is recommended for the treatment of early localized or early disseminated Lyme disease associated with erythema migrans 1.
- Doxycycline is relatively contraindicated during pregnancy or lactation and in children <8 years of age, but may be used in certain situations under the guidance of a healthcare professional 1.
- The use of doxycycline for the prevention of Lyme disease after a tick bite is recommended in certain circumstances, such as when the tick can be reliably identified as an adult or nymphal Ixodes scapularis tick that is estimated to have been attached for 36 hours, and prophylaxis can be started within 72 hours of the time that the tick was removed 1.
From the FDA Drug Label
To reduce the development of drug-resistant bacteria and maintain effectiveness of doxycycline hyclate and other antibacterial drugs, doxycycline hyclate should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria Treatment: Doxycycline is indicated for the treatment of the following infections: Doxycycline is also indicated for the treatment of infections caused by the following gram-negative microorganisms: Doxycycline is indicated for treatment of infections caused by the following gram- negative microorganisms, when bacteriologic testing indicates appropriate susceptibility to the drug: Doxycycline is indicated for treatment of infections caused by the following gram-positive microorganisms when bacteriologic testing indicates appropriate susceptibility to the drug: Doxycycline is used to treat various infections caused by bacteria, including:
- Respiratory tract infections
- Skin infections
- Urinary tract infections
- Sexually transmitted infections
- Malaria prophylaxis 2
From the Research
Doxycycline Overview
- Doxycycline is an antibiotic used to treat various bacterial infections, including Lyme disease 3, 4, 5.
- It is often prescribed orally, with a typical dosage of 100 mg twice daily for 21 days 4.
Efficacy of Doxycycline for Lyme Disease
- Studies have shown that doxycycline is effective in treating Lyme disease, with a clinical cure rate of around 88% 4.
- However, a network meta-analysis found that doxycycline did not have a significant advantage in efficacy and safety for treating Lyme disease compared to other antibiotics 6.
- Doxycycline has been shown to be effective in preventing the late manifestations of Lyme disease in patients with acute disseminated infection 4.
Comparison with Other Antibiotics
- Doxycycline has been compared to ceftriaxone in the treatment of acute disseminated Lyme disease, with similar clinical cure rates 4.
- A study found that amoxicillin, azithromycin, ceftriaxone, and cefotaxime were effective for treating Lyme disease, but doxycycline was not found to have significant efficacy and safety 6.
- Cefuroxime and penicillin were found to be safe for treating Lyme disease, but doxycycline was not evaluated for safety in this study 6.
Special Considerations
- Doxycycline may not be suitable for patients with certain medical conditions, such as pregnancy or liver disease 5.
- Single-dose doxycycline (200 mg orally) can be used as prophylaxis in selected patients to prevent Lyme disease 5.
- A case report found that doxycycline, in combination with ceftriaxone, induced seroconversion in a patient with clinically suspected disseminated Lyme disease 7.