From the Guidelines
Tetracyclines are contraindicated in children under 8 years of age due to the risk of permanent tooth discoloration, and their use should be limited in adults due to potential side effects and antibiotic resistance, as reported in a 2024 study 1.
Indications and Usage
Tetracyclines are broad-spectrum antibiotics primarily indicated for treating infections caused by susceptible gram-positive and gram-negative bacteria, atypical organisms, and some protozoa. Common indications include:
- Respiratory tract infections
- Urinary tract infections
- Acne
- Rosacea
- Lyme disease
- Rocky Mountain spotted fever
- Chlamydia
- Alternative therapy for malaria The typical adult dose ranges from 250-500mg taken 2-4 times daily depending on the specific tetracycline and infection severity, usually for 7-14 days.
Side Effects and Precautions
Common side effects include:
- Gastrointestinal disturbances (nausea, vomiting, diarrhea)
- Photosensitivity (increased risk of sunburn)
- Permanent tooth discoloration in children under 8 years Tetracyclines can also cause esophageal irritation, so patients should take them with a full glass of water and remain upright for 30 minutes after. These antibiotics work by binding to the 30S ribosomal subunit, inhibiting bacterial protein synthesis. They should be avoided during pregnancy and breastfeeding as they can affect fetal bone development and cause dental staining. Tetracyclines may reduce the effectiveness of oral contraceptives and should not be taken with dairy products, antacids, or iron supplements as these can reduce absorption.
Recent Guidelines and Recommendations
A 2019 study 1 highlights the concerns regarding the use of oral antibiotics for the management of acne, including the risk of antibiotic resistance and disruption of the microbiome. The study suggests limiting the use of oral antibiotics and exploring alternative treatments, such as novel topical agents, dietary modification, and laser and light-based modalities. Additionally, a 2024 study 1 provides guidance on the use of tetracyclines in patients with blepharitis, recommending their use in patients with chronic symptoms and signs not adequately controlled by eyelid cleansing or meibomian gland expression.
From the FDA Drug Label
To reduce the development of drug-resistant bacteria and maintain the effectiveness of tetracycline hydrochloride and other antibacterial drugs, tetracycline hydrochloride should be used only to treat infections that are proven or strongly suspected to be caused by susceptible bacteria Tetracycline hydrochloride tablets are indicated in the treatment of infections caused by susceptible strains of the designated organisms in the conditions listed below: Upper respiratory tract infections caused by Streptococcus pyogenes, Streptococcus pneumoniae and Hemophilus influenzae Lower respiratory tract infections caused by Streptococcus pyogenes, Streptococcus pneumoniae, Mycoplasma pneumoniae (Eaton agent, and Klebsiella sp.) Skin and soft tissue infections caused by Streptococcus pyogenes, Staphylococcus aureaus. Infections caused by rickettsia including Rocky Mountain spotted fever, typhus group infections, Q fever, rickettsialpox. Psittacosis caused by Chlamydophila psittaci. Infections caused by Chlamydia trachomatis such as uncomplicated urethral, endocervical or rectal infections, inclusion conjunctivitis, trachoma, and lymphogranuloma venereum. Granuloma inquinale caused by Klebsiella granulomatis Relapsing fever caused by Borrelia sp. Bartonellosis caused by Bartonella bacilliformis. Chancroid caused by Hemophilus ducreyi. Tularemia caused by Francisella tularensis. Plaque caused by Yersinia pestis. Cholera caused by Vibrio cholerae. Brucellosis caused by Brucella species (tetracycline hydrochloride tablets may be used in conjunction with an aminoglycoside) Infections due to Campylobacter fetus. As adjunctive therapy in intestinal amebiasis caused by Entamoeba histolytica. Urinary tract infections caused by susceptible strains of Escherichia coli, Klebsiella, etc. Other infections caused by susceptible gram-negative organisms such as E. coli, Enterobacter aerogenes, Shigella sp., Acinetobacter sp., Klebsiella sp., and Bacteroides sp. In severe acne, adjunctive therapy with tetracycline hydrochloride tablets may be useful When penicillin is contraindicated, tetracyclines are alternative drugs in the treatment of the following infections: Syphilis and yaws caused by Treponema pallidum and pertenue, respectively, Vincent's infection caused by Fusobacterium fusiforme, Infections caused by Neisseria gonorrhoeae, Anthrax caused by Bacillus anthracis, Infections due to Listeria monocytogenes, Actinomycosis caused by Actinomycesspecies, Infections due to Clostridiumspecies.
The indications for tetracycline hydrochloride tablets include:
- Upper respiratory tract infections
- Lower respiratory tract infections
- Skin and soft tissue infections
- Infections caused by rickettsia
- Psittacosis
- Infections caused by Chlamydia trachomatis
- Granuloma inquinale
- Relapsing fever
- Bartonellosis
- Chancroid
- Tularemia
- Plaque
- Cholera
- Brucellosis
- Infections due to Campylobacter fetus
- Intestinal amebiasis
- Urinary tract infections
- Infections caused by susceptible gram-negative organisms
- Severe acne
- Syphilis and yaws
- Vincent's infection
- Infections caused by Neisseria gonorrhoeae
- Anthrax
- Infections due to Listeria monocytogenes
- Actinomycosis
- Infections due to Clostridium species
The side effects are not explicitly listed in the provided text, therefore, no conclusion can be drawn about the side effects of tetracycline hydrochloride tablets 2
From the Research
Tetracycline Indications
- Tetracycline and its derivatives are used to treat various conditions, including:
- Acne 3, 4
- Soft tissue bacterial infections 3, 5, 6
- Lyme disease (borreliosis) 3
- Chlamydial infections 3
- Respiratory tract infections 3, 5
- Skin and skin structure infections (SSTIs) 6, 7
- Meningococcal prophylaxis 5
- Central nervous system infections (due to susceptible organisms) 5
- Staphylococcal infections (when tetracycline is indicated) 5
- Prostatitis 5
- Venereal diseases 5
- Intraabdominal/pelvic sepsis or trauma 5
- Atypical pneumonias 5
- Upper respiratory tract infections 5
Tetracycline Side Effects
- Although the provided studies do not explicitly mention side effects, they discuss the suitability and safety of tetracyclines for various uses 3, 5
- The studies also mention the development of antibiotic resistance and gut dysbiosis as potential concerns associated with the use of oral tetracyclines 4