Doxycyclin - The forgotten antimicrobial drug

Background: Doxycycline is an broad-spectrum antimicrobial agent, it remain s an inexpensive alternative for the treatment of community-acquired respir atory infections and urinary tract infections. Despite these clinical data the use of doxycycline has decreased during the last years. Pharmacology: Adverse effects and resistance to therapy are infrequent and not different to fluoroquinolones and macrolide antibiotics. Gastrointestin al and phototoxic side effects are of importance. After oral administration 75% will be absorbed and largely eliminated by the hepatic and intestinal way. Contraindications are severe liver dysfunction and treatment in childh ood. Clinical Indications: Bacterial resistance to doxycycline has a low inciden ce in Germany. A therapeutic success can be expected in respiratory and uri nary tract infections in about 80%. Doxycycline is the drug of choice for t reating infections caused by Rickettsia, Borrelia, Ehrlichia. It shows good activity against-Plasmodium falciparum as one part in a combination therap y. Daily costs of therapy are low, in oral administration DM 0,80 per day, in i.v. administration DM 22,- per day. Conclusion: Despite competition from new antibiotics, doxycycline can retai n an important place in the treatment of many infectious diseases.