Dr. Murai Éva szerk.: Parasitologia Hungarica 26. (Budapest, 1993)

DOXYCYCLIN - CHINOIN capsule Doxycycline is a broad-spectrum antibiotic synthetized from Oxytetracycline. The compound exerts its bacteriostatic effect by inhibiting bacterial protein synthesis. The antibacterial spectrum of doxycycline is practically the same as that of other tetracyclines. Cross-resistance with other tetracyclines almost always occurs. Doxycycline has numerous advantages over other tetracyclines: its absorption is almost complete when administered orally: food and milk can hardly influence its absorption: it is bound to plasma proteins in a higher degree; has a longer elimination half-life (it is enough to administer it once or twice daily); it has better lipid solubility (penetrates a number of tissues e.g.endometrium, myometrium, prostate and kidneys); its elimination is independent of the hepatic and renal functions (it can be administered also to patients with hepatic or renal disease) it binds with lower affinity to calcium. Active ingredient: Each capsule contains 100 mg doxycyclinum (in the form of doxycyclinum hydrochloricum) Indications: First of all infections of the respiratory and urogenital tracts, soft tissues, ophthalmic, gastrointestinal tract, gallbladder, and biliary tract caused by the following pathogens: a/ Doxycyclin is the drug of first choice in infections caused by the following microorganisms,: Mycoplasma pneumoniae, Mycoplasma hominis, Ureaplasma urealyticum, Chlamydia trachomatis, Myagawanella, Bordetella pertussis, Brucella (in combination with streptomycin). Haemophilus ducreyi, and also against pathogens more rarely occurring in our country like: Rickettsia, Borrelia recurrentis, Pasteurella, Vibrio cholerae. b/ In the treatment of Lyme borreliosis, also in its erythema chronicum migrans (ECM) and arthritic stages. c/ In case the antibiogram shows sensitivity, it can be administered against: Escherichia coli, Enterobacter group, Shigella, Heamophilus influenzae, Klebsiella, Salmonella, Streptococcus strains (Str. pyogenes, Str. viridans, Str. pneumoniae) Enterococcus faecalis, Staphylococcus aureus, Staphylococcus epidermidis (In Streptococcus caused infections of the upper respiratory tract penicillin should be given). In case penicillin is contraindicated: Neisseria gonorrhoeae, N. meningitidis, Treponema pallidum, Listeria monocytogenes, Clostridium strains, Bacillus anthracis, Fusobacterium fusiforme, atypical mycobacteriae, Actinomyces strains. c/ Gynaecologycal inflammatory diseases and reproduction problems: (sterility, habitual abortion) caused by Mycoplasma hominis, Ureaplasma urealyticum, Chlamydia trachomatis; exclusively before the planned pregnancy. f/ Other pathogens: Plasmodium falciparum (if resistant to other antimalarial drugs), Entamoeba histolytica (as adjuvant to antiamebic preparation) Contraindications: Relative contraindications: Hypersensitivity to tetracyclines. The administration of doxycycline in pregnancy, nursing and to children under 8 years of age should be the last resort. Dosage: The usual dosage and the frequency of administration differ from that of other tetracyclines! Exceeding the recommended dosage may result in an increased incidence of side-effects. The usual dose for adults on the first day of treatment is 200 mg /100 mg twice daily at 12-hour interval/, then the maintenance dose is 1 capsule daily. After the cessation of symptoms or fever treatment should be continued for at least an additional 24-48 hours. In more severe cases: 100 mg at 12-hour intervals is recommended: In Mycoplasma hominis, Ureaplasma urealyticum, Chlamydia trachomatis caused gynecological inflammations, /often clinically symptom-free cervicitis, endometritis, etc./ and secondary reproduction problems caused by the above bacteriae /sterility, habitual abortion/ only before the planned pregnancy, treatment course with Doxycyclin can be recommended for the simultaneous treatment of the patient and his/her sexual partner. On the first day 200 mg, then for the subsequent 10 days 100 mg daily doses should be taken by both the patient and his/her sexual partner. On day 11th bacteriological control examination should be performed. In case of positivity treatment should be continued for another 10 days. In the ECM stage and arthritis of Lyme borreliosis 100 mg should be administered twice daily over 30 days. The patient's attention has to be drawn to the photosensitizing effect of the drug. In acute gonococcal infection: men should take 300 mg on the first day (200 mg in the morning and 100 mg in the evening ) then 1 capsule twice daily for 3 days: women should take 100 mg twice daily until complete recovery. In primary and secondary syphilis: three times 100 mg daily for at least 10 days.