Abstract

CLINICAL PHARMACOLOGY OF DOXYCYCLINE IN CHILDREN

Prof. 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 a bacteriostatic antibiotic and 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, methicillin-resistant Staphylococcus aureus, Bacillus anthracis, Listeria monocytogenes, most strains of Brucella, Rickettsia, Coxiella burnetii, Mycoplasma pneumoniae, Chlamydia species, Legionella species, Ureaplasma, some atypical mycobacteria, Plasmodium species, spirochetes, including Borrelia recurrentis, Borrelia burgdorferi (Lyme disease), Treponema pallidum (syphilis), and Treponema pertenue. In children, doxycycline is usually administered by a loading dose followed by a maintenance dose. Doxycycline has been found efficacy and safe in children and the pharmacokinetics of doxycycline have been studied in children. The elimination half-life, the total body clearance, and the distribution volume of doxycycline are about 17 hours, 0.05 L/h/kg, and 1.3 L/kg, respectively. The prophylaxis, treatment, and trials with doxycycline have been reviewed in children. Doxycycline penetrates into the cerebrospinal fluid in significant amounts and treats Lyme meningitis and the meningitis caused by multi-resistant Acinetobacter baumannii, Neisseria meningitidis serotype B, and Lyme neuroborreliosis. The aim of this study is to review the published data on doxycycline dosing, efficacy and safely, pharmacokinetics, prophylaxis, treatment, trials, penetration into the cerebrospinal fluid, and treatment of bacterial meningitis in children.

Keywords: CSF, dosing, doxycycline, meningitis, pharmacokinetics, prophylaxis, treatment, and trials.