What is the proper administration of doxycycline (antibiotic)?

From the Guidelines

Doxycycline should be taken 100 mg twice per day with 8 ounces of fluid to reduce the risk of esophageal irritation and with food to reduce gastrointestinal intolerance. This is based on the guidelines provided by the Infectious Diseases Society of America, as stated in the study published in Clinical Infectious Diseases 1. It is essential to take doxycycline exactly as prescribed by your healthcare provider, and to complete the full course of treatment, even if symptoms improve before finishing.

Some key points to consider when taking doxycycline include:

• Taking it at least 1 hour before or 2 hours after meals to minimize absorption issues
• Avoiding concurrent use with antacids, calcium supplements, iron products, or magnesium-containing products, as these can bind to doxycycline and prevent proper absorption
• Staying upright for at least 30 minutes after taking the medication to prevent esophageal irritation
• Avoiding sun exposure while taking doxycycline, as it can increase sensitivity to sunlight and potentially cause severe sunburn
• If a dose is missed, taking it as soon as possible, but skipping it if it's almost time for the next dose.

It's worth noting that doxycycline is relatively contraindicated in children under 8 years of age and in women who are pregnant or breastfeeding, as mentioned in the study 1. The most recent and highest quality study, which is the 2006 guidelines for the treatment of Lyme disease 1, provides the most relevant information for this question.

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 Administration of adequate amounts of fluid along with capsule and tablet forms of drugs in the tetracycline class is recommended to wash down the drugs and reduce the risk of esophageal irritation and ulceration. If gastric irritation occurs, it is recommended that doxycycline be given with food or milk. The absorption of doxycycline is not markedly influenced by simultaneous ingestion of food or milk.

Doxycycline should be taken as follows:

• Adults: 200 mg on the first day (100 mg every 12 hours), then 100 mg/day
• With adequate amounts of fluid to reduce the risk of esophageal irritation
• If gastric irritation occurs, take with food or milk
• Food or milk does not significantly affect absorption 2

From the Research

Dosage and Administration of Doxycycline

• Doxycycline is typically taken orally, with a single dose of 200 mg used as prophylaxis in selected patients 3.
• The dosage and administration of doxycycline may vary depending on the specific treatment guidelines and patient population.

Treatment Guidelines

• Doxycycline is the primary treatment option for Lyme disease, but it can have unwanted off-target effects and kill beneficial bacteria 4.
• Alternative treatment options, such as amoxicillin, azithromycin, ceftriaxone, and cefotaxime, have shown efficacy and safety in treating Lyme disease 5.

Special Considerations

• Single-dose doxycycline may be underprescribed for certain groups, including children 6.
• Doxycycline therapy may induce seroconversion in patients with clinically suspected disseminated Lyme disease 7.

Patient Populations

• Residents of the coastal Northeast, northwest California, and the Great Lakes region are at highest risk for Lyme disease 3.
• Children and those spending extended time outdoors in wooded areas are also at increased risk 3.