Doxycycline Dosage for Skin Infections
The recommended dosage of doxycycline for skin infections in adults is 100 mg twice daily for 7-14 days. 1, 2
Adult Dosing Regimen
- Initial dose: 200 mg on the first day (100 mg every 12 hours) 2
- Maintenance dose: 100 mg twice daily for 7-14 days 1, 2
- For mild to moderate infections, 100 mg twice daily is sufficient 1, 2
- For severe infections, the treatment duration may be extended but should generally not exceed 14 days 1
Pediatric Dosing Regimen
- For children over 8 years of age weighing ≤100 pounds (45 kg): 2 mg/lb (4.4 mg/kg) divided into two doses on first day, followed by 1 mg/lb (2.2 mg/kg) daily as a single dose or divided into two doses 2
- For children over 8 years of age weighing >100 pounds (45 kg): use adult dosage (100 mg twice daily) 2
- Doxycycline should not be used in children under 8 years of age due to risk of permanent tooth discoloration and enamel hypoplasia 3
Clinical Considerations
Efficacy for Different Types of Skin Infections
- Doxycycline is effective against a wide range of pathogens causing skin and soft tissue infections 1
- It has good activity against Eikenella species, staphylococci, and anaerobes, though some streptococci may be resistant 1
- For methicillin-resistant Staphylococcus aureus (MRSA) skin infections, doxycycline is an effective oral treatment option 3
Special Populations
- Pregnancy: Doxycycline is generally contraindicated in pregnancy but may be used for life-threatening infections when benefits outweigh risks 1
- Breastfeeding: Use with caution; consider alternative antibiotics if possible 3
- Renal impairment: No dosage adjustment is typically required 3
Administration Guidelines
- Take with adequate amounts of fluid to reduce risk of esophageal irritation 2
- May be taken with food or milk if gastric irritation occurs, though this may slightly reduce absorption 2
- Complete the full course of therapy even if symptoms improve before completion 1
Common Pitfalls and Considerations
- Inadequate duration of therapy (less than 7 days) may lead to treatment failure 3
- Photosensitivity reactions can occur; patients should avoid excessive sun exposure 4
- Gastrointestinal side effects (nausea, vomiting, diarrhea) are common but usually mild 4
- For specific infections requiring longer treatment:
Alternative Dosing Approaches
- Low-dose doxycycline (20-40 mg twice daily) has been studied for inflammatory skin conditions like acne and rosacea, but is not recommended for active skin infections 5, 6, 7, 8
- For standard skin infections, the full antimicrobial dose (100 mg twice daily) is necessary to achieve clinical cure 1, 2
Remember that the duration of therapy should be guided by clinical response, with most uncomplicated skin infections resolving with 7-14 days of treatment 1, 2.