From the FDA Drug Label
Adults: The usual dose of oral doxycycline is 200 mg on the first day of treatment (administered 100 mg every 12 hours) followed by a maintenance dose of 100 mg/day In the management of more severe infections (particularly chronic infections of the urinary tract), 100 mg every 12 hours is recommended
The recommended dose of doxycycline for the treatment of cellulitis is 100 mg every 12 hours or 200 mg on the first day followed by 100 mg/day.
- The dose may vary depending on the severity of the infection. 1
From the Research
The recommended dose of doxycycline for the treatment of cellulitis is typically 100 mg taken orally twice daily (every 12 hours) for 5-14 days, depending on the severity of the infection. This recommendation is based on the most recent and highest quality studies available, including a study published in 2020 2, which found that the route of antibiotic administration (oral vs. intravenous) did not affect the outcome of treatment for cellulitis. Another study published in 2020 3 found that a 6-day course of antibiotic therapy was not inferior to a 12-day course in terms of clinical outcome, but was associated with a higher rate of relapse.
The duration of treatment with doxycycline is usually 5-7 days for uncomplicated cases and may be extended to 10-14 days for more severe infections. Doxycycline should be taken with a full glass of water, and patients should remain upright for at least 30 minutes after taking it to prevent esophageal irritation. It can be taken with or without food, though taking it with food may reduce stomach upset. Patients should be advised to complete the full course of antibiotics even if symptoms improve before completion.
Doxycycline works by inhibiting bacterial protein synthesis, preventing bacteria from growing and multiplying. It's effective against many of the common bacteria that cause cellulitis, including streptococci and staphylococci. However, in areas with high MRSA prevalence, additional coverage may be necessary. Patients should avoid taking doxycycline with dairy products, antacids, or supplements containing calcium, magnesium, aluminum, or iron, as these can reduce absorption of the medication.
Some key points to consider when treating cellulitis with doxycycline include:
- The severity of the infection and the patient's overall health status
- The presence of any underlying medical conditions, such as diabetes or immunosuppression
- The potential for antibiotic resistance, particularly in areas with high MRSA prevalence
- The importance of completing the full course of antibiotics to ensure effective treatment and prevent relapse
Overall, doxycycline is a effective and well-tolerated antibiotic for the treatment of cellulitis, and its use should be guided by the most recent and highest quality evidence available, including studies such as those published in 2020 2, 3.