What is the dosage and frequency of Doxycycline (Doxy) for cellulitis?

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From the Guidelines

Doxycycline for Cellulitis: 100 mg PO BID.

Dosage and Frequency

The dosage and frequency of Doxycycline (Doxy) for cellulitis is 100 mg orally twice a day 1.

  • This dosage is recommended for adults, with a pediatric dose of <45kg: 2 mg/kg/dose PO every 12 h.
  • The treatment duration is typically 5 to 10 days, but should be individualized based on the patient’s clinical response.

Evidence Summary

The evidence from the Infectious Diseases Society of America (IDSA) guidelines supports the use of doxycycline as an oral antibiotic option for empirical coverage of CA-MRSA in outpatients with skin and soft tissue infections (SSTIs), including cellulitis 1.

  • Doxycycline is effective against CA-MRSA, but its activity against β-hemolytic streptococci is not well-defined.
  • Clindamycin, trimethoprim-sulfamethoxazole (TMP-SMX), and linezolid are also recommended as oral antibiotic options for empirical coverage of CA-MRSA.
  • The choice of antibiotic should be based on the patient’s clinical presentation, local epidemiology, and susceptibility patterns.

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 dosage and frequency of Doxycycline for cellulitis is 100 mg every 12 hours for more severe infections, or 200 mg on the first day (administered 100 mg every 12 hours) followed by a maintenance dose of 100 mg/day 2.

From the Research

Dosage and Frequency of Doxycycline for Cellulitis

  • The provided studies do not directly address the dosage and frequency of Doxycycline for cellulitis. However, some studies provide information on the treatment of cellulitis and the use of Doxycycline in general 3, 4, 5, 6, 7.
  • A study on the assessment of antibiotic treatment of cellulitis and erysipelas found that there is no evidence to support the superiority of any one antibiotic over another, including Doxycycline, and that treatment duration of longer than 5 days was not supported by evidence 5.
  • Another study compared the efficacy of low and high doses of Doxycycline in modulating inflammatory responses, but did not specifically address the treatment of cellulitis 6.
  • A review of Doxycycline's chemistry, mode of action, antimicrobial activity, pharmacokinetics, and therapeutic efficacy found that it is highly effective in infections of the skin and soft tissue, but did not provide specific guidance on dosage and frequency for cellulitis 7.
  • The dosage and frequency of Doxycycline for cellulitis are not explicitly stated in the provided studies, and therefore, cannot be determined based on the available evidence 3, 4, 5, 6, 7.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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