To reduce the development of drug-resistant bacteria and maintain effectiveness of doxycycline and other antibacterial drugs, doxycycline should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
Treatment
Doxycycline is indicated for the treatment of the following infections
Rocky Mountain spotted fever, typhus fever and the typhus group, Q fever, rickettsialpox, and tick fevers caused by Rickettsiae.
Respiratory tract infections caused by
Mycoplasma pneumoniae.
Lymphogranuloma venereum caused by
Chlamydia trachomatis.
Psittacosis (ornithosis) caused by
Chlamydophila psittaci.
Trachoma caused by
Chlamydia trachomatis, although the infectious agent is not always eliminated, as judged by immunofluorescence.
Inclusion conjunctivitis caused by
Chlamydia trachomatis.
Uncomplicated urethral, endocervical, or rectal infections in adults caused by
Chlamydia trachomatis.
Nongonococcal urethritis caused by
Ureaplasma urealyticum.
Relapsing fever due to
Borrelia recurrentis.
Doxycycline is also indicated for the treatment of infections caused by the following gram-negative microorganisms:
Chancroid caused by
Haemophilus ducreyi.
Plague due to
Yersinia pestis.
Tularemia due to
Francisella tularensis.
Cholera caused by
Vibrio cholerae.
Campylobacter fetus infections caused by
Campylobacter fetus.
Brucellosis due to
Brucella species (in conjunction with streptomycin).
Bartonellosis due to
Bartonella bacilliformis.
Granuloma inguinale caused by
Klebsiella granulomatis.
Because many strains of the following groups of microorganisms have been shown to be resistant to doxycycline, culture and susceptibility testing are recommended.
Doxycycline is indicated for treatment of infections caused by the following gram-negative bacteria when bacteriologic testing indicates appropriate susceptibility to the drug:
Escherichia coli.
Enterobacter aerogenes.
Shigella species.
Acinetobacter species.
Respiratory tract infections caused by
Haemophilus influenzae.
Respiratory tract and urinary tract infections caused by
Klebsiella species.
Doxycycline is indicated for treatment of infections caused by the following gram-positive microorganisms when bacteriologic testing indicates appropriate susceptibility to the drug:
Upper respiratory infections caused by
Streptococcus pneumoniae.
Anthrax due to
Bacillus anthracis, including inhalational anthrax (post-exposure): to reduce the incidence or progression of disease following exposure to aerosolized
Bacillus anthracis.
When penicillin is contraindicated, doxycycline is an alternative drug in the treatment of the following infections:
Uncomplicated gonorrhea caused by
Neisseria gonorrhoeae.
Syphilis caused by
Treponema pallidum.
Yaws caused by
Treponema pallidum subspecies
pertenue.
Listeriosis due to
Listeria monocytogenes.
Vincent's infection caused by
Fusobacterium fusiforme.
Actinomycosis caused by
Actinomyces israelii.
Infections caused by
Clostridium species.
In acute intestinal amebiasis, doxycycline may be a useful adjunct to amebicides.
In severe acne, doxycycline may be useful adjunctive therapy.
Prophylaxis
Doxycycline is indicated for the prophylaxis of malaria due to Plasmodium falciparum in short-term travelers (<4 months) to areas with chloroquine and/or pyrimethamine-sulfadoxine resistant strains. (See
DOSAGE AND ADMINISTRATION section and
INFORMATION FOR PATIENTS subsection of the
PRECAUTIONS section.)