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Doxycycline / Vibramycin

- See: Tetracycline

- Discussion:
- broad spectrum antibiotic, for rickettsiae, chlamydia, mycoplasma pneumoniae, bacteroides, useful for chronic bronchitis,
& prostatitis;
- tetracycline of choice w/ renal impairment; long acting;
- adult: 100mg PO q12hr/day #1, then, 100mg/day or 50mg/day PO bid or 100-200mg/day IV qd;
- peds: > 8yrs: 5 mg/kg/day PO or IV, divided q 12hr; Contraindicated in pregnancy and in children < 8yrs;
- supplied: tabs: 50mg, 100mg; caps: 50mg, 100mg; powder for injection 100mg, 200mg per vial;
- take with food to avoid nausea;

- Hazards:
- photosensitivity;
- absorption will be decreased by aluminum, iron, bismuth, and Mg salts;
- half life decreased by barbituates, phenytoin, and tegertol, and bicarbonate will decrease absorption and incr clearance
of doxyclcline;
- digoxin will increase serum levels;
- renal failure; 60mg PO qid;;
- ratio of CSF to blood level (%): normal meninges: 13;
- inflammed meninges: 18; dosing regimens for patients with renal
- insufficiency (dose for 70kg adult {gm/dosing interval in hours}):
CrCl >80: 0.1/12; CrCl 50-79; 0.1/12; CrCl: 30-49; 0.1/12; CrCl:10-29: 0.1/12;
- 40 % of dose will be excreted in urine (w/ nl R F(x)) over 72 hrs

- role of Doxycycline in tendon repair:
- nonspecific inhibition of MMPs using doxycycline protected the muscle from reperfusion injury
- Doxycycline-Mediated Inhibition of Matrix Metalloproteinases Improves Healing After Rotator Cuff Repair

Images in clinical medicine. Minocycline-induced hyperpigmentation.

Intra-articular administration of doxycycline in calves.



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