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Antimicrobials

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Doxycycline

Guidelines for use

IV doxycycline is available upon request via Health Canada’s Special Access Program (SAP).

Prescribing is restricted to Infectious Diseases.

Please click on the titles below to read more:

1. Spectrum of Activity

Active against:

  • Streptococci – activity is variable (consider C&S to tetracyclines prior to treating Streptococcal infections)
  • Staphylococci (including MRSA, MRSE) – activity is variable (consider C&S to tetracyclines prior to treating Staphylococcal infections)
  • Gram negative aerobic bacteria – activity is variable (consider C&S to tetracyclines prior to treating Gram negative infections)
  • Mycoplasma spp.
  • Chlamydia spp.
  • Legionella spp.
  • Other (Suggest an ID Consult): Brucella spp, Propionibacterium acnes, Vibrio cholera, Bacillus anthracis, Bartonella spp, Rickettsiae spp, Coxiella spp, Plasmodium spp.

Not active against:

  • Enterococcus
  • Pseudomonas

2. Clinical Use

Appropriate Uses:

  • Monotherapy for outpatient treatment of community-acquired pneumonia
  • Treatment of susceptible Staphylococcal skin and soft tissue infections
  • Sexually transmitted infections caused by Chlamydia trachomatis
  • Treatment of infections due to the following organisms (Suggest an ID consult): Brucella spp, Propionibacterium acnes, Vibrio cholera, Bartonella spp, Rickettsiae spp, Coxiella spp, Plasmodium spp

Inappropriate Uses:

  • Combination therapy with levofloxacin for community-acquired pneumonia
  • Monotherapy for community-acquired pneumonia requiring hospitalization
  • Meningitis and other CNS infections
  • Monotherapy for the treatment of serious Gram positive infections such as septicemia or endocarditis requiring bactericidal activity

3. Precautions

  • Contraindicated in children < 8 years of age
  • Hypersensitivity to tetracyclines
  • Pregnancy and breastfeeding - for safety information, see Table on Safety of Anti-infective therapy in Pregnancy & Lactation

4. Adverse Effects

  • Nausea, vomiting, diarrhea, abdominal pain
  • Photosensitivity
  • Esophageal ulceration – oral doses should be taken with a full glass of water

5. Dosage

  • Usual: 100 mg PO BID (taken with a full glass of water)
  • Renal insufficiency: No dose reduction is required

IV doxycycline is available upon request via Health Canada’s Special Access Program (SAP).
Prescribing is restricted to Infectious Diseases.