Will doxycycline (antibiotic) cover bacterial skin infections?

From the Guidelines

Doxycycline is effective for many skin infections, including those caused by Staphylococcus aureus, Streptococcus species, and many gram-negative bacteria, as supported by the most recent evidence from 1 and 1. The typical adult dosage is 100mg twice daily for 7-14 days, depending on infection severity. For children, the dose is typically 2-4mg/kg/day divided into two doses. Doxycycline is particularly useful for skin infections because it achieves good tissue penetration and has anti-inflammatory properties in addition to its antimicrobial effects. However, it may not cover all possible skin pathogens, particularly certain resistant bacteria or fungal infections. Some key points to consider when using doxycycline for skin infections include:

• Side effects can include photosensitivity (increased sun sensitivity), gastrointestinal upset, and it should be taken with food and plenty of water to prevent esophageal irritation.
• Doxycycline should be avoided in pregnancy and children under 8 years due to potential effects on bone development and tooth discoloration.
• If the infection shows no improvement after 48-72 hours of treatment, reevaluation is recommended. It's also important to note that doxycycline can be used as an alternative to other antibiotics, such as vancomycin, for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections, as suggested by 1 and 1. Overall, doxycycline is a viable option for the treatment of many skin infections, but its use should be guided by the most recent evidence and clinical judgment.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Doxycycline Coverage for Skin Infections

• Doxycycline is a synthetic tetracycline that has been shown to be effective against a range of skin and soft tissue infections, including those caused by methicillin-resistant Staphylococcus aureus (MRSA) 2, 3, 4.
• The 2014 Infectious Diseases Society of America (IDSA) skin and soft tissue guideline strongly recommends sulfamethoxazole/trimethoprim, clindamycin, and tetracyclines, including doxycycline, as oral treatment options for patients with purulent skin and soft tissue infections (SSTIs), especially when MRSA is of clinical concern 3.
• Doxycycline has been shown to have bacteriostatic activity against clindamycin resistance-inducible isolates of CA-MRSA, although its effectiveness may be impacted by inoculum size 4.
• In some cases, doxycycline may not be effective in eradicating skin and soft tissue infections, particularly those caused by MRSA, and alternative treatments such as minocycline or vancomycin may be necessary 2, 5.

Mechanisms of Resistance and Susceptibility

• The effectiveness of doxycycline against skin and soft tissue infections can be impacted by the development of resistance, particularly in MRSA strains 2, 4.
• Doxycycline has been shown to have good activity against a range of SSTI pathogens, including Staphylococcus aureus, Streptococcus pyogenes, and Escherichia coli 3.
• The susceptibility profiles of doxycycline against common SSTI pathogens, as well as its pharmacokinetics and pharmacodynamics, are important considerations in its use as a treatment option for skin and soft tissue infections 3.

Clinical Uses and Applications

• Doxycycline is commonly used in dermatology for the treatment of a range of conditions, including acne, rosacea, and hidradenitis suppurativa 6.
• Doxycycline has anti-inflammatory properties that make it suitable for the treatment of non-infectious conditions, such as hair follicle diseases and granulomatous diseases 6.
• The use of doxycycline in the treatment of skin and soft tissue infections is supported by clinical guidelines and evidence-based practice 5, 3.