Doxycycline and the Teeth

A Comparative Trial of a Single Dose of Azithromycin versus Doxycycline for the Treatment of Mild Scrub Typhus

“…However, the adequacy of this regimen has not been evaluated in well-designed, controlled studies [31]. The antimicrobial treatment of scrub typhus in pregnant women and children is problematic because treatment of these patients with tetracyclines or chloramphenicol is not recommended [17,18]. Although the use of macrolides for the treatment of scrub typhus in pregnant women and children has been successful in South Korea, there have been no clinical trials to determine which macrolide is optimal.…”

“…The successful treatment of scrub typhus with macrolides has been reported for children and pregnant women, for whom tetracyclines and chloramphenicol are not recommended [12][13][14][15][16][17][18]. Azithromycin attains high intracellular concentrations and is effective in vitro against doxycycline-resistant strains of scrub typhus; thus, it might be a suitable alternative therapeutic agent [19,20].…”

QUESTION 1: Teething issues: can doxycycline be safely used in young children?

“…Only one study investigated exposure in young infants aged <2 months 4. This retrospective cohort study of 25 premature infants reported one case of ‘slight spotted discolouration of the upper incisors with faint positive fluorescence’ when examined 1 year later 4.…”

Recognition of and Prompt Treatment for Tick-Borne Infections in Children

“…Although this side effect was seen in children who received repeated courses of tetracycline, published studies have not found evidence of dental staining among children treated with doxycycline. [23][24][25][26] Unlike doxycycline, chloramphenicol is linked to serious toxicities, including life-threatening aplastic anemia, and it requires monitoring of serum levels owing to its unpredictable pharmacokinetics. The oral formulation of chloramphenicol was withdrawn from the US market in 1995 and is no longer available.…”