Oxytetracycline Dosage and Treatment Regimen for Bacterial Infections
For bacterial infections, oxytetracycline should be administered at a dose of 75 mg/kg body weight subcutaneously every 3 days for initial treatment, followed by transition to an oral tetracycline for maintenance therapy. 1
General Dosing Information
Injectable Oxytetracycline
- Injectable long-acting oxytetracycline (LA-200®) can be administered subcutaneously at 75 mg/kg body weight every 3 days 1
- This formulation causes irritation at the injection site and is best used for initiating treatment in severely ill patients or those reluctant to eat 1
- After stabilization with oxytetracycline injection, patients should be transitioned to oral therapy to reduce muscle irritation from repeated injections 1
Oral Oxytetracycline
- For adults with skin infections such as acne, the recommended oral dose is 500 mg per day 2
- For more severe bacterial infections, transition to oral doxycycline (100 mg twice daily) is often preferred after initial injectable therapy 1
Treatment Duration
- For most bacterial infections, treatment should continue for 7-10 days 1
- For chronic or complicated infections, longer treatment courses may be necessary 1
Clinical Applications
Skin and Soft Tissue Infections
- Oxytetracycline is effective for primary and secondary skin infections with inflammatory reactions 2
- For papulopustular acne, rosacea, and perioral dermatitis, oxytetracycline at 500 mg daily is considered effective 2
- For more severe skin infections, injectable oxytetracycline followed by oral tetracycline therapy is recommended 1
Respiratory Tract Infections
- While oxytetracycline can be used, doxycycline (100 mg twice daily) is generally preferred for upper respiratory tract infections and atypical pneumonias 3
- Oxytetracycline has activity against respiratory pathogens but is not the first-line agent 3
Other Infections
- Effective against Pasteurella multocida in animal bite infections 1
- Can be used for certain zoonotic infections 1
Important Considerations and Precautions
Contraindications
- Not recommended for children under 8 years of age due to risk of dental staining and bone growth effects 1
- Use with caution during pregnancy 1
Adverse Effects
- Local irritation at injection sites with injectable formulations 1
- Potential for gastrointestinal upset with oral formulation 4
- May increase antimicrobial resistance in normal flora with prolonged use 4
Antimicrobial Resistance
- Studies show increased tetracycline resistance in subgingival, gastrointestinal, and upper respiratory tract flora after 2-18 weeks of tetracycline use 4
- Resistance effects are generally modest and transient 4
Alternative Tetracycline Options
- Doxycycline (100 mg twice daily) is often preferred over oxytetracycline for many infections due to better pharmacokinetics 1, 3
- Minocycline is preferred for meningococcal prophylaxis and certain staphylococcal infections 3
- Newer tetracyclines (eravacycline, omadacycline, tigecycline) may be considered for resistant infections 5
Clinical Pearls
- Intramuscular administration of tetracyclines is generally not recommended due to tissue reactions 3
- Transition from injectable to oral therapy as soon as clinically appropriate to minimize injection site reactions 1
- Oral tetracyclines should be taken with adequate water and not with dairy products, antacids, or iron supplements, which can reduce absorption 6