From the Guidelines
Doxycycline can be used to treat skin infections or abscesses, particularly those caused by Staphylococcus aureus (including some MRSA strains) and Streptococcus species. The recommended dose is 100 mg twice daily for 7-14 days, depending on infection severity 1. Doxycycline works well as an adjunct to drainage procedures, which remain the primary treatment for abscesses. Some key considerations for doxycycline use include:
- Taking the medication with a full glass of water and remaining upright for 30 minutes to prevent esophageal irritation
- Taking the medication with food if stomach upset occurs, though dairy products may reduce absorption
- Avoiding sun exposure due to increased photosensitivity
- Completing the full course of antibiotics even if symptoms improve quickly
- Avoiding use in pregnant women and children under 8 years due to potential effects on bone development and tooth discoloration Doxycycline's effectiveness stems from its ability to inhibit bacterial protein synthesis and its excellent tissue penetration 1. It is essential to note that doxycycline can be used safely in children ages 2 years and older when given for durations less than 2 weeks 1. For complex abscesses, such as perianal and perirectal, and abscesses in intravenous drug injection sites, antibiotic therapy is recommended if systemic signs of infection are present, in immunocompromised patients, if source control is incomplete, or in cases of abscess with significant cellulitis 1. In these cases, empiric broad-spectrum antibiotic therapy with coverage of Gram-positive, Gram-negative, and anaerobic bacteria is recommended 1. Overall, doxycycline is a viable option for treating skin infections and abscesses, but its use should be guided by the severity of the infection, the causative agent, and local patterns of susceptibility.
From the Research
Doxycycline for Skin Infections/Abscesses
- Doxycycline can be used to treat skin infections or abscesses, particularly those caused by community-acquired methicillin-resistant Staphylococcus aureus (MRSA) 2.
- However, the effectiveness of doxycycline in treating uncomplicated skin and soft-tissue abscesses caused by MRSA is limited, and it often fails to eradicate the infection 2.
- In some cases, minocycline may be a more effective treatment option for uncomplicated cutaneous abscesses due to MRSA, especially when doxycycline or trimethoprim-sulfamethoxazole fails 2.
- Doxycycline has anti-inflammatory properties, making it suitable for treating non-infectious conditions in dermatology, such as hair follicle diseases and granulomatous diseases 3.
- The use of doxycycline has decreased in recent years, despite its efficacy and safety profile, due to the availability of newer antibiotics 4.
- While doxycycline can be used to treat skin infections, other antibiotics like clindamycin and trimethoprim-sulfamethoxazole may be more effective in certain cases, such as uncomplicated skin infections or abscesses 5, 6.
Treatment Options
- Clindamycin and trimethoprim-sulfamethoxazole are commonly used to treat uncomplicated skin infections, including abscesses, and have shown similar efficacy and safety profiles 5.
- Trimethoprim-sulfamethoxazole has been shown to be superior to placebo in treating uncomplicated skin abscesses, particularly in settings where MRSA is prevalent 6.
- Doxycycline may be considered as an alternative treatment option for skin infections or abscesses, especially when other antibiotics are not effective or suitable 2, 3, 4.