Abstract

CLINICAL PHARMACOLOGY OF DOXYCYCLINE IN CHILDREN

Gian Maria Pacifici*

ABSTRACT

Doxycycline is a tetracycline which is used in children but not in infants. Doxycycline inhibits bacterial protein synthesis by binding to the 30S bacterial ribosome and preventing access of aminoacyl tRNA to the acceptor (A) site on the mRNA-ribosome complex. Doxycycline is more active against gram-positive than gram-negative bacteria. Doxycycline is active against Streptococcus pyogenes, penicillin-susceptible streptococci, penicillin-resistant Streptococcus pneumoniae, methicillin-sensitive Staphylococcus aureus, Bacillus anthracis, Listeria monocytogenes, Haemophilus influenzae, Burkholderia pseudomallei, Brucella, spirochetes including Borrelia recurrentis, Borrelia burgdorferi (Lyme disease), Legionella species, Ureaplasma, atypical mycobacteria, Treponema pallidum (syphilis), and Treponema pertenue. The oral dose of doxycycline in children is usually 200 mg once-daily or 100 twice-daily for treating different bacterial infections. Doxycycline has been found efficacy and safe in children but may induce adverse-effects and some of these may be common. The elimination half-life is about 20 hours in children indicating that doxycycline is slowly eliminated, and the total body clearance ranges for 0.04 to 0.07 but these pharmacokinetic parameters are not influenced by age. The distribution volume ranges from 1.6 to 1.3 L/kg and decreases with child ageing. Prophylaxis, treatment, and trials with doxycycline have been extensively studied. Doxycycline penetrates the cerebrospinal fluid in significant amounts and cured meningitis caused by Acinetobacter baumannii and Lyme meningitis. The aim of this study is the review of the published data on doxycycline dosing, efficacy and safety, adverse-effects, pharmacokinetics, prophylaxis, treatment, trials, penetration into the cerebrospinal fluid and the treatment of meningitis in children.

Keywords: Doxycycline, Dosing, Pharmacokinetics, Treatment, Cerebrospinal fluid, Meningitis.