Doxycycline Solution Tablets

Doxycycline ~ Antibiotic, tetracycline

Price in pharmacies from 221.60 to 274.00 rubles*

Doxycycline Solution Tablets is a broad-spectrum antibiotic from the tetracycline group. It acts bacteriostatically, suppresses protein synthesis in the microbial cell by interacting with the 30S ribosomal subunit. Active against many gram-positive and gram-negative microorganisms: Streptococcus spp., Treponema spp., Staphylococcus spp., Klebsiella spp., Enterobacter spp. (including E. aerugenes), Neisseria gonorrhoeae, Neisseria meningitidis, Haemophilus influenzae, Chlamydia spp., Mycoplasma spp., Ureaplasma urealyticum, Listeria monocytogenes, Rickettsia spp., Typhus exanthematicus, Escherichia coli, Shigella spp., Campylobacter fetus, Vibrio cholerae, Yersinia spp. (including Yersinia pestis), Brucella spp., Francisella tularensis, Bacillus anthracis, Bartonella bacilliformis, Pasteurella multocida, Borrelia recurrentis, Clostridium spp. (except Clostridium difficile), Actinomyces spp., Fusobacterium fusiforme, Calymmatobacterium granulomatosis, Propionibacterium acnes, some protozoa (Entamoeba spp., Plasmodium falciparum). More about the drug »

ATTENTION! ALWAYS check with your doctor or pharmacist to see if the found analogue can serve as a full replacement for the drug prescribed to you or the drug you are looking for. This is due to the need to use the dosage forms and doses prescribed specifically for you, which may differ even among analogues (more about analogues of drugs).

pharmachologic effect

Manufacturer: OZONE LLC (Russia)
Release form: capsules, solution in ampoules for intravenous administration

Active ingredient: doxycycline hydrochloride

Analogues: Azithromycin, Amoxicillin, Ciprofloxacin

Doxycycline is part of the pharmacological group of tetracyclines. The medication has a bacteriostatic and antibacterial effect. An antibiotic, affecting protein biosynthesis in a microbial cell, disrupts its connections. The drug is active against a wide range of gram-positive and gram-negative bacteria.

Indications for use of Doxycycline

An antibiotic is prescribed for diseases caused by pathogenic microorganisms sensitive to Doxycycline:

• infectious processes in the respiratory system (bronchitis, pneumonia, lung abscess);
• infections in ENT organs (tonsillitis, otitis, tonsillitis);
• infectious diseases of the gastrointestinal tract and biliary tract (cholangitis, cholecystitis, bacterial dysentery, pancreatitis);
• infections of soft tissues and skin (furunculosis, abscesses, phlegmon);
• infectious processes in the urinary system (pyelonephritis, prostatitis, endometritis, cystitis);
• infectious eye diseases.

The medication is used as a prophylaxis to prevent the development of infections after general and orthopedic surgical interventions, abortions.

Brief information about the drug

® therapy is prescribed if the following pathogens are present in the body:

1. Gram+ flora:

• aerobic cocci (staphylococci, including those producing penicillase, streptococci);
• spore-forming aerobes (the causative agent of anthrax);
• non-spore-forming anaerobes (listeria);
• spore-forming anaerobes (clostridia).

1. Gram+flora

• aerobic cocci (gonorrhea)
• aerobic bacteria (Escherichia coli, Shigella, Salmonella, Enterobacteriaceae, Klebsiella, Bordetella);
• other microorganisms (rickettsia, treponema, mycoplasma and chlamydia)

The medicine will not help treat fungal and viral infections. Pseudomonas aeruginosa, Proteus, Bacteroides and Serratia also show resistance to Doxycycline®.

Once in the body, the drug immediately begins to spread throughout the tissues and intercellular space. Due to the high degree of absorption from the gastrointestinal tract, after 2.5 hours 90-100% of the substance is distributed unchanged to target organs. These include bone tissue, liver and spleen, prostate gland and eye tissue. The antibiotic crosses the placenta and can accumulate in fetal tissues. Excreted through the gastrointestinal tract and kidneys.

Read further: Instructions for use of doxycycline® + reviews from doctors

Indications

List of diseases for which doxycycline can be used:

• bacterial infections of the upper and lower respiratory tract (from pharyngitis to pneumonia complicated by pleurisy);
• diseases of the ENT organs (otitis media, sinusitis, tonsillitis, inflammation of the tonsils, etc.);
• disorders of the gastrointestinal tract (enterocolitis, gastroenteritis, proctitis, cholecystitis);
• eye lesions (keratitis, conjunctivitis);
• problems with the urinary system (cystitis, urethritis);
• inflammation of the pelvic organs in women;
• infectious and inflammatory processes in the skin and bones;
• diseases of the external genitalia in women and men;
• prevention of postoperative complications.

The antibiotic should not be prescribed to children under nine years of age, pregnant or lactating women. This is due to the deposition of the active substance of the drug in the bones. If there is nothing to replace the drug, then the woman must stop breastfeeding during therapy. It should also not be taken if you have lactose intolerance or deficiency, leukopenia, severe renal failure, porphyria, glucose-galactose malabsorption and allergies to tetracyclines.

The medication is not prescribed for meningitis, since it practically does not enter the cerebrospinal fluid and does not penetrate the blood-brain barrier. The cost of the original in pharmacies is from 16 rubles.

Read further: Choosing antibiotics for acne on the face and body

Doxycycline - instructions for use

According to the instructions for use of Doxycycline, the medication is prescribed on the 1st day of treatment at a dosage of 200 mg, followed by taking the medication at 100–200 mg 1–2 times a day. The maximum daily dose is 300 mg, which can be increased according to indications.

How to take Doxycycline: before or after meals

The antibiotic must be taken orally after meals. The capsule is swallowed whole without violating its integrity. Take the medicine with a sufficient amount of water.

Instructions:

Clinical and pharmacological group

06.018 (tetracycline group antibiotic)

pharmachologic effect

Semi-synthetic antibiotic of the tetracycline group with a broad spectrum of action. It has a bacteriostatic effect by suppressing the protein synthesis of pathogens.

Active against aerobic gram-positive bacteria: Staphylococcus spp. (including strains producing penicillinase), Streptococcus spp. (including Streptococcus pneumoniae), Bacillus anthracis, Listeria monocytogenes; anaerobic bacteria: Clostridium spp.

Doxycycline is also active against aerobic gram-negative bacteria: Neisseria gonorrhoeae, Escherichia coli, Shigella spp., Salmonella spp., Enterobacter spp., Klebsiella spp., Bordetella pertussis, as well as against Rickettsia spp., Treponema spp., Mycoplasma spp. and Chlamydia spp.

Pseudomonas aeruginosa, Proteus spp., Serratia spp., and most strains of Bacteroides fragilis are resistant to doxycycline.

Pharmacokinetics

After oral administration, it is quickly and almost completely absorbed from the gastrointestinal tract. Food intake has little effect on the absorption of doxycycline. Widely distributed in tissues and body fluids. Plasma protein binding is 80-95%. T1/2 is 12-22 hours. It is excreted unchanged in the urine (40%), but the main part of the dose is excreted unchanged in the feces due to the secretion of bile.

Dosage

Adults are prescribed 200 mg/day orally or intravenously (drip) on the first day of treatment, and 100-200 mg/day on subsequent days. Frequency of administration (or intravenous infusion) is 1-2 times/day. For children over 8 years of age and weighing more than 50 kg, the daily dose for oral administration or intravenous administration (drip) is 4 mg/kg on the first day of treatment. In the following days - 2-4 mg/kg/day, depending on the severity of the clinical course of the disease. Frequency of administration (or intravenous infusion) is 1-2 times/day. The recommended minimum time for IV infusion of 100 mg doxycycline (at an infusion solution concentration of 0.5 mg/ml) is 1 hour.

Maximum doses: for adults for oral administration - 300 mg/day or 600 mg/day (depending on the etiology of the pathogen); for intravenous administration - 300 mg/day.

Drug interactions

Drugs containing metal ions (antacids, drugs containing iron, magnesium, calcium) form inactive chelates with doxycycline, and therefore their simultaneous administration should be avoided.

When used simultaneously with barbiturates, carbamazepine, phenytoin, the concentration of doxycycline in the blood plasma decreases due to the induction of microsomal liver enzymes, which may cause a decrease in its antibacterial effect.

It is necessary to avoid combination with penicillins, cephalosporins, which have a bactericidal effect and are antagonists of bacteriostatic antibiotics (including doxycycline).

The absorption of doxycycline is reduced by cholestyramine and colestipol (keep an interval of at least 3 hours between doses).

Due to the suppression of intestinal microflora, doxycycline reduces the prothrombin index, which requires dose adjustment of indirect anticoagulants.

Taking doxycycline reduces the reliability of contraception and increases the incidence of breakthrough bleeding while taking estrogen-containing oral contraceptives.

The simultaneous use of retinol increases intracranial pressure.

Use during pregnancy and lactation

Doxycycline is contraindicated for use during pregnancy and lactation. Doxycycline crosses the placental barrier. May cause long-term discoloration of teeth, enamel hypoplasia, suppression of fetal skeletal bone growth, and the development of fatty liver.

If necessary, use during lactation should stop breastfeeding.

Side effects

From the digestive system: nausea, vomiting, anorexia, abdominal pain, diarrhea, constipation, dysphagia, glossitis, esophagitis, transient increase in blood levels of liver transaminases, alkaline phosphatase, bilirubin.

From the hematopoietic system: neutropenia, thrombocytopenia, hemolytic anemia.

Allergic reactions: skin rash, itching, eosinophilia, rarely - Quincke's edema, photosensitivity.

Other: increased residual nitrogen, candidiasis, intestinal dysbiosis, discoloration of teeth in children.

Indications

Infectious and inflammatory diseases caused by microorganisms sensitive to doxycycline, incl. infections of the respiratory and ENT organs; gastrointestinal infections; purulent infections of the skin and soft tissues (including acne); infections of the genitourinary system (including gonorrhea, primary and secondary syphilis); typhus, brucellosis, rickettsiosis, osteomyelitis, trachoma, chlamydia.

Contraindications

Pregnancy, children under 8 years of age (possibility of formation of insoluble complexes with calcium in the bone skeleton, enamel and dentin of teeth), hypersensitivity to tetracyclines, porphyria, severe liver failure, leukopenia, lactation period, myasthenia gravis (for intravenous administration).

special instructions

Use doxycycline with caution in cases of liver dysfunction. In case of impaired renal function, no dose adjustment is required.

To prevent local irritation (esophagitis, gastritis, ulceration of the gastrointestinal tract), it is recommended to take it during the daytime with plenty of liquid, food or milk. Due to the possible development of photosensitivity, it is necessary to limit insolation during treatment and for 4-5 days after it.

Doxycycline is not used in children under 8 years of age, because tetracyclines (including doxycycline) cause long-term discoloration of teeth, enamel hypoplasia and slower longitudinal growth of skeletal bones in this category of patients.

Doxycycline solution for intravenous administration should be used no later than 72 hours after its preparation.

Preparations containing DOXYCYCLINE

• DOXYCYCLINE HYDROCHLORIDE in capsules. 100 mg: 10 pcs. • DOXYCYCLINE caps. 100 mg: 10 pcs. • DOXYCYCLINE HYDROCHLORIDE in capsules. 100 mg: 10 pcs. • DOXYCYCLINE HYDROCHLORIDE in capsules. 50 mg: 10 pcs. • DOXYCYCLINE caps. 100 mg: 10 or 20 pcs. • DOXYCYCLINE HYDROCHLORIDE in capsules. 50 mg: 10 pcs. • DOXYCYCLINE HYDROCHLORIDE caps. 50 mg: 10 or 20 pcs. • DOXYCYCLINE caps. 100 mg: 10, 20, 30, 50 or 100 pcs. • DOXYCYCLINE HYDROCHLORIDE in capsules. 50 mg: 10 pcs. • DOXYCYCLINE-FEREIN lyophilisate for preparation. r-ra d/inf. 100 mg: amp. 5 pcs., fl. 50 pcs. • DOXYCYCLINE caps. 50 mg: 10 or 20 pcs. • DOXYCYCLINE-AKOS caps. 100 mg: 10 or 20 pcs. • DOXYCYCLINE HYDROCHLORIDE in capsules. 50 mg: 10 pcs. • DOXYCYCLINE HYDROCHLORIDE in capsules. 100 mg: 10 pcs. • XEDOCINE® tab. 100 mg: 10 or 20 pcs. • DOXYCYCLINE-FEREIN caps. 100 mg: 10 or 20 pcs. • UNIDOX SOLUTAB® tab. dispersible 100 mg: 10 or 25,000 pcs. • DOXYCYCLINE-FEREIN caps. 50 mg: 10 or 20 pcs. • DOXYCYCLINE caps. 100 mg: 10 pcs. • DOXYCYCLINE HYDROCHLORIDE in capsules. 50 mg: 10 pcs. • VIDOKCINE lyophilisate for preparation. solution for intravenous administration 100 mg: vial. 1 PC. • DOXYCYCLINE HYDROCHLORIDE in capsules. 200 mg: 10 pcs. • DOXYCYCLINE lyophilisate for preparation. r-ra d/inf. 200 mg: amp. 5, 10 pcs. • UNIDOX SOLUTAB® tab. dispersible 100 mg: 10 pcs. • DOXYCYCLINE-FEREIN caps. 200 mg: 10 or 20 pcs. • DOXYCYCLINE HYDROCHLORIDE in capsules. 100 mg: 10 pcs. • DOXYCYCLINE HYDROCHLORIDE in capsules. 50 mg: 10 pcs. • DOXYCYCLINE HYDROCHLORIDE caps. 100 mg: 10 or 20 pcs. • DOXYCYCLINE HYDROCHLORIDE in capsules. 100 mg: 10 pcs. • DOXYCYCLINE HYDROCHLORIDE in capsules. 200 mg: 10 pcs. • XEDOCINE® tab. 200 mg: 10 or 20 pcs. • DOXYCYCLINE HYDROCHLORIDE in capsules. 100 mg: 10 pcs. • DOXYCYCLINE lyophilisate for preparation. r-ra d/inf. 200 mg: fl. 5, 10 pcs. • DOXYCYCLINE HYDROCHLORIDE caps. 100 mg: 10 or 20 pcs. • DOXYCYCLINE HYDROCHLORIDE in capsules. 100 mg: 10 pcs. • DOXYCYCLINE HYDROCHLORIDE caps. 100 mg: 10 pcs. • DOXYCYCLINE HYDROCHLORIDE in capsules. 50 mg: 10 pcs. • DOXYCYCLINE caps. 100 mg: 10 or 20 pcs. • DOXYCYCLINE caps. 100 mg: 10 or 20 pcs. • DOXYCYCLINE HYDROCHLORIDE in capsules. 200 mg: 10 pcs. • DOXYCYCLINE HYDROCHLORIDE in capsules. 50 mg: 10 pcs. • DOXYCYCLINE caps. 100 mg: 10, 20, 30, 40 or 50 pcs. • DOXYCYCLINE lyophilisate for preparation. r-ra d/inf. 100 mg: amp. 5, 10 pcs. • DOXYCYCLINE-FEREIN lyophilisate for preparation. r-ra d/inf. 100 mg: fl. • DOXAL caps. 100 mg: 10, 20 or 30 pcs. • DOXYCYCLINE lyophilisate for preparation. r-ra d/inf. 100 mg: fl. 5, 10 pcs. • DOXYCYCLINE HYDROCHLORIDE in capsules. 100 mg: 10 pcs.

Doxycycline analogs

The pharmaceutical market is represented by a wide range of analogues of the antibiotic Doxycycline from various manufacturers. This type of medicine is the most popular in practical medicine. The pharmacy chain sells Doxycycline substitutes in the form of:

• generics;
• synonyms:
• combined means.

A large selection of antibiotic analogues allows the doctor to choose the most appropriate medication for the disease and the degree of its activity, which can effectively cope with the infection.

Table of Doxycycline analogues with price and country of origin.

The price of Doxycycline analogues varies widely. Some imported analogues are more expensive than antibiotics from domestic manufacturers. The cost of the medication does not affect the effect of treatment. You can buy domestic analogues of Doxycycline cheaper and with a good result of the therapeutic effect of the drug.

What else can replace Doxycycline in gynecology and surgery? The list can be supplemented with the following antibiotics:

• Suprax;
• Metronidazole;
• Tsifran;
• Augmentin 1000;
• Levofloxacin;
• Erythromycin;
• Sumamed;
• Josamycin.

This is not a complete list of drugs used in medical practice. Among them are analogs of Doxycycline in new generation tablets that are highly active against a wide range of bacterial pathogens.

Modern analogues of Doxycycline®

Similarities between Bassado®, Doxibene® capsules, Doxycycline AKOS® and Doxy-M® tablets

Due to the high percentage of binding to plasma proteins (80-95), the half-life of these drugs takes from 12 to 22 hours. A significant portion of drugs is excreted in the feces, which allows them to be prescribed to people with minor kidney problems. 1-2 times a day is enough to cause positive changes in the affected ENT organs, respiratory and urinary systems. Side effects may include changes in the blood picture, dyspeptic symptoms and anaphylaxis.

These 4 antibiotics are united not only by the active substance (Doxycycline®). They are in the same price category. Italian Bassado® costs from 104 rubles, Austrian Doxybene® from 115 and Russian Doxycycline AKOS® from 128 rubles per pack. The price of Doxy-M® is 120 rubles.

Unidox Solutab®

359 rub.

The imported analogue of Doxycycline®, supplied to Russia from the Netherlands, is available only in tablet form (1 tablet 100 mg). Concomitant food intake does not affect the absorption of Unidox® components. Active against Gram+ and Gram+ microbial flora.

Assigned to:

• infectious processes localized in the genitourinary system, upper and lower respiratory tract, gastrointestinal tract;
• severe pustular diseases of the skin.

Effective for typhus.

Doxycycline® 100 and 200 Studs

1625 rub.

Another analogue of Doxycycline® in tablets is the German Doxycycline Stada®. It is available only in tablet form (100 and 200 mg tablets). Directions for use: after meals, wash down the product with plenty of water (this is necessary to prevent irritation of the walls of the esophagus). The average daily dose in adults and children over 12 years of age is 200 mg on the 1st day and 100 mg on subsequent days.

For the treatment of urinary tract lesions, 0.2 g/day is prescribed throughout the entire treatment period. Syphilis is treated for about 10 days, 0.3 g per day. Treatment of prostatitis requires a 4-week course of therapy at 200 mg daily. The maximum daily dose in adults is up to 0.3 g per day or up to 0.6 g per day for five days when treating gonorrhea.

Doxycycline Rivo® and Doxycycline Ferein®: only the original is cheaper

17-18 rub.

Switzerland and Russia produce analogues of the original medicine. The drugs act against infections of the following localization:

• respiratory organs (pharyngitis, acute bronchitis, pneumonia and bronchopneumonia);
• urinary tract (acute and chronic cystitis, prostatitis, inflammation of the endometrium and ovaries, gonorrhea);
• gastrointestinal tract infections (gastritis, enteritis, shigellosis);
• infectious lesions of the skin and soft tissues;
• eye diseases.

These medications are also used to prevent purulent-necrotic complications after major operations.

Doskycycline preparations should not be prescribed together with antacids containing Al, Ca and Mg, as well as iron preparations, sodium salts and magnesium containing laxatives.

Doxycycline Nycomed® and Monoclin®

1632 and 1625r respectively.

The first drug comes to us from Denmark, the second from France. All 3 medications are available in 100 mg tablets, which is very convenient in the treatment of certain diseases. Thus, therapy for sexually transmitted diseases and urinary tract infections involves taking 0.1 g of the drug twice daily for a week. The drug is taken orally (by mouth) with enough liquid to prevent esophageal damage. Using the medicine while dental tissue is forming has an adverse effect on its color.

Medomycin® and Unidox®

The drug produced in Cyprus differs from Jordanian Unidox® only in the manufacturing method, the quality of raw materials and the cost of testing the pharmaceutical drug. As a result, both cost practically in the same price category (219 and 272 rubles) and perform similar functions. They are prescribed in ENT practice, in the complex treatment of inflammation of the lungs and genitourinary system in men and women, and are often recommended for ulcerative keratitis.

During long courses of therapy, monitoring the cellular composition of peripheral blood and liver enzyme levels is recommended.

Tetradox® or Apo-Doxy®?

Capsules of 0.1 g are produced by pharmaceutical companies in India and Russia, presenting the world with new generation analogues of Doxycycline®. Both have a cost of around 1630 rubles. However, they also have side effects:

• CNS: intracranial hypertension (ICH), weakness, dizziness;
• metabolism: anorexia;
• vision: blurred vision, blind spots in the field of vision (scotomas), double vision;
• Gastrointestinal tract: constipation or diarrhea, pain, nausea, stomach or duodenal ulcer, gastritis;
• allergies (from redness and itching of the skin to anaphylaxis and total swelling);
• heart: tachycardia, drop in blood pressure;
• musculoskeletal system: pain in joints and muscles;
• changes in the blood picture (eosinophilia, decrease in the number of neutrophils and platelets, increased transaminase activity);
• change in tooth color.

Novo-Doxilin® and Doxidar®

1625 rub.
Both Canadian and Jordanian antibiotics are aimed at destroying bacteria that are sensitive to it. But it is necessary to adjust the treatment while taking antacids, iron supplements and laxatives containing magnesium. All of these agents reduce the absorption of the active component of the tetracycline derivative. The use of ethanol and psychoactive substances (barbiturates, carbamazepine) can alter the metabolism of Doxyclin®, reducing the therapeutically significant concentration of the drug in the blood plasma.

Vibramycin®

240 rub.

This analogue has many dosage forms:

• capsules (0.1g);
• syrup (0.01g/ml);
• oral solution;
• solution for intravenous or intramuscular administration (0.1g);
• powder for the preparation of injection solution (0.2g).

With repeated use, the drug may accumulate in the body. To prevent esophageal ulcers, Vibramycin® should be taken with plenty of water. In case of renal or liver failure, if it is impossible to replace this tetracycline, treatment is carried out under the monitoring of the condition of the liver and kidneys.

Doxycycline or Unidox Solutab - which is better, what is the difference

Manufacturer: ZiO-Zdorovye (Russia)
Release form: tablets

Active ingredient: doxycycline monohydrate

Both drugs have equivalent indications, but a different mechanism of action. Doxycycline has the active substance doxycycline hydrochloride, and its analog Unidox Solutab is doxycycline monohydrate. The difference between medications is their chemical structure. Product 1 contains a water molecule, and product 2 contains hydrogen chloride elements.

Despite the slight differences in the structure of the drugs, side effects will vary when taking these antibiotics. According to doctors, Unidox Solutab is softer and safer. It is well tolerated by patients and has fewer side effects.

Doxycycline or Azithromycin - which is better?

Manufacturer: VERTEX (Russia)
Release form: capsules

Active ingredient: azithromycin

Both antibiotics have a wide spectrum of action and an equivalent therapeutic effect. But Azithromycin will be better, since the analogue Azithromycin has more indications for use and is recommended for patients with allergies and gastrointestinal diseases.

If renal function is impaired, Doxycycline will be an advantage, since the drug is eliminated primarily through the liver.

Doxycycline in rheumatology: problems and prospects

IN

In the 21st century, infectious pathology remains one of the most significant problems in medicine. In rheumatology, the relevance of this issue is due to at least two factors. Currently, the role of various infectious agents in the development of rheumatic diseases (RD) is well known and proven, in which microorganisms play a trigger role, triggering immunopathological mechanisms of inflammation. An equally difficult task is the fight against concomitant infections, which often complicate the course of many RDs.

Despite the extensive arsenal of antimicrobial agents developed and introduced into clinical practice in the second half of the last century, issues of rational therapy of infectious pathology still require the closest attention.

both medical scientists and practical doctors of various specialties. Identification of new pathogens, the growing role of opportunistic microflora, an increase in the number of resistant microorganisms, inferiority of the immune response, issues of tolerability and interaction with antirheumatic drugs, pharmacoeconomic aspects - all this requires constant awareness of the rheumatologist about the basic principles of rational therapy of bacterial infections in RD.

The emergence of new antibacterial agents in recent years has significantly expanded the possibilities of practical antimicrobial therapy both in rheumatology and in all medicine. At the same time, in a number of clinical situations, time-tested, much less expensive antibacterial agents still retain their importance. The latter includes doxycycline.

Doxycycline

– a semisynthetic antibiotic from the tetracycline group – was created in 1967 and has been widely used in clinical practice for many years. Its chemical structure is 6-dioxy-5-oxytetracycline and has a mechanism of action common to all tetracyclines. At clinically achievable concentrations, it acts bacteriostatically, disrupting protein synthesis in the microbial cell by binding to the 30 S RNA subunit of ribosomes.

Compared to tetracycline, doxycycline has a number of pharmacokinetic advantages (Table 1): a greater degree of absorption from the gastrointestinal tract and less influence of food and milk on this process; longer half-life (which allows you to prescribe the drug 1-2 times a day); good penetration into various tissues due to its lipophilicity; the absence of cumulation of the drug in the blood due to increased excretion in feces and increased metabolism in case of impaired renal function, which makes it possible to use it in patients with renal failure. Due to its special pharmacokinetic properties, doxycycline is much easier to tolerate than tetracycline. Side effects are even rarer when taking Unidox Solutab

. The neutral reaction of doxycycline monohydrate eliminates the occurrence of esophagitis that occurs when using other forms of doxycycline. Consequently, the successful combination of the chemical formula (monohydrate) and dosage form (soluble Solutab tablets) makes the drug the safest, and treatment with its help the most compliant.

Doxycycline, like other tetracyclines, is a broad-spectrum antibiotic, but over many years of use, many bacteria have become resistant to it.
In particular, more than 50% of S. pyogenes strains, the vast majority of enterococci, and many gonococci are resistant to the drug. Most strains of E. coli, Salmonella, Shigella, and Enterobacter are also highly resistant to the drug. Based on the above, doxycycline is not used for A-streptococcal tonsillitis, urinary tract infections, gonorrhea, etc. At the same time, it retains its importance as a first-line drug for many infections and in a number of situations can be used as an alternative remedy ( Table 2). Works in recent years have shown that doxycycline, like other tetracyclines, also has other properties that make it possible to talk about expanding the indications for the use of these drugs, in particular for RD.

Doxycycline has found wide use in the treatment of sexually transmitted diseases, since Chlamydia trachomatis is one of the most significant factors in these diseases.
According to the Center for Disease Control (CDC), in 1999 in the United States, the incidence of chlamydial infections was 254 cases per 100,000 population. Chlamydial infections were most often found in young women aged 15–24 years [3]. This pathogen accounts for 30–50% of cases of nongonococcal urethritis; much less frequently, U. urealyticum and M. genitalium (10–20%) appear as etiological factors. In accordance with CDC recommendations [4], for the treatment of patients with acute nongonococcal urethritis,
doxycycline 100 mg orally twice a day for 7 days or azithromycin 1 g orally once is used. According to numerous studies, the effectiveness of both regimens is approximately the same, but the cost of treatment with azithromycin is significantly higher than when using doxycycline.

A significant proportion of chlamydial infections are asymptomatic, especially in women, and can lead to infertility and pelvic inflammatory disease. In these cases, as with nongonococcal urethritis, doxycycline and azithromycin are first-line drugs. It should be remembered that doxycycline, like other tetracyclines, should not be given to children under 8 years of age, since these drugs can cause slower bone growth, discoloration of teeth, and enamel hypoplasia. Given the possibility of tetracyclines passing through the placenta, as well as into breast milk, they are contraindicated during pregnancy and lactation.

Doxycycline is used in combination with other antibiotics

(ampicillin/sulbactam, ciprofloxacin, metronidazole) for the treatment of inflammatory diseases of the pelvic organs, as well as in patients with syphilis with intolerance to b-lactam antibiotics.

Given the sensitivity of the main respiratory pathogens to doxycycline, the drug remains important in the empirical treatment of infectious exacerbations of chronic bronchitis, as well as community-acquired pneumonia that does not require hospitalization, especially in young people. In case of proven chlamydial or mycoplasma etiology of community-acquired pneumonia, doxycycline, along with macrolides, is used as a first-line agent.

Reactive arthritis

The leading role in the pathogenesis of reactive arthritis (ReA), including Reiter's disease (RD), is played by an infectious focus in the genitourinary tract. In this case, Chl is recognized as the most significant etiological agent. trachomatis. This pathogen as a trigger triggers immunopathological processes in the human body, leading to the occurrence and maintenance of joint inflammation. Persistence of infection, in turn, leads to recurrence and chronicity of the articular process in ReA.

The role of Chl. trachomatis in urogenic ReA is confirmed by the presence of this infectious agent in scrapings of the epithelium of the urethra and cervical canal (where there are signs of nongonococcal inflammation), the detection of chlamydial antigens in the synovial fluid of patients, and the detection of DNA and RNA of this pathogen in the synovial fluid and tissue.

Numerous studies have substantiated the advisability of early prescription of antibiotics for ReA

associated with chlamydial infection. This allows you to control the pathological process, and in some cases prevent the development of joint damage. Although no convincing data have been obtained on the effect of antibiotics on the course of articular syndrome, when chlamydial infection is eliminated, relapses and chronicity of the disease occur less frequently.

It should be noted that sanitizing the body of a patient with ReA from chlamydial infection is a rather difficult task. It has been shown that with urogenic ReA in almost all patients, the inflammatory process in the urogenital tract is not limited to the urethra, but spreads to its overlying parts, which significantly complicates the sanitation of this focus. [5]. This circumstance, to a certain extent, may serve as an explanation for the fact that 7–10 day courses of antibiotic therapy used to treat uncomplicated urogenital chlamydia are completely ineffective for ReA associated with chlamydial infection. However, even with adequate long-term antimicrobial therapy, the rate of bacteriological failures in BD can reach 40%, which is apparently due to the biological characteristics of the pathogen.

It is known that the carriers of the species characteristics of chlamydia - elementary bodies - are metabolically inactive, exist in the extracellular environment and can remain dormant for an indefinitely long time. Moreover, patients with ReA who have previously been treated with antibiotics may develop a persistent infection, when the initially metabolically active reticular bodies localized inside the cell stop at a certain stage of development and do not turn into elementary bodies. These intermediate forms, compared to conventional ones, are smaller in size and are not sensitive to the action of antibiotics.

Antibiotics of the tetracycline group have been used to treat BD since the late 1970s. Thus, long-term use of high daily doses (up to 2 g/day) of tetracycline in fresh cases of BD gave a significantly better therapeutic effect than when using relatively small doses (up to 1 g/day) [6]. The advantages of a 6-week course of treatment with tetracycline for BD in relation to indicators of chlamydial infection and joint syndrome compared with a 2-week period of therapy have been shown [7]. Use of lymecycline in patients with ReA for 3 months. made it possible to achieve a more rapid reverse development of both individual symptoms (arthralgia, accelerated ESR, increased levels of C-reactive protein) and the disease as a whole [8]. A comparative study examined the effectiveness of doxycycline, prescribed at a dose of 200 mg/day for 2 weeks or 4 months, in 42 patients with ReA, while the duration of the disease was more than 6 months. Remission was achieved in 73 and 82%, respectively, but the differences were not statistically significant [9].

In general, recognizing the need for long-term use of antibiotics (including doxycycline) for ReA associated with chlamydial infection, it should be noted that there is no consensus on treatment regimens in the world literature. Extending the duration of treatment (more than 3 months), as well as parenteral administration of antibiotics, is unlikely to increase the effectiveness of therapy [10]. Further clinical studies are needed to resolve this issue.

Lyme borreliosis

In recent years, Lyme borreliosis (LB), an infectious natural focal disease caused by spirochetes of the genus Borrelia and transmitted by ixodid ticks, has attracted increasing interest from medical specialists, including rheumatologists. First attracting attention in 1975 during a local outbreak of arthritis in Lyme (USA), BL is currently considered as a multisystem disease that affects not only the musculoskeletal system, but also the skin, nervous system, heart, liver, and eyes. etc. After Borrelia penetrates the skin, erythema with centrifugal growth appears at the site of tick suction (tick-borne migratory erythema - TME), which reflects the early stage of the disease. Subsequently, dissemination of the pathogen from the primary skin lesion to various organs and its persistence in tissues (stage of late manifestations) may occur.

Rheumatic manifestations typical of BL (arthritis and arthralgia, tendonitis, myositis, enthesopathies, fibrositis) develop after dissemination of the causative agent to the target organs. Neurological manifestations of BL are represented by symptoms indicating damage to both the central (meningitis, encephalitis, myelitis, encephalopathy) and peripheral nervous system (cranial neuropathies, radiculopathy, etc.). The most typical signs of heart damage, developing 3–12 weeks from the onset of the disease, are atrioventricular blocks of varying severity (from first to complete) [11].

It has been shown that early (i.e. prescribed for CME) antibacterial therapy reduces the risk of developing secondary erythema, damage to joints and blood vessels and, therefore, is an important factor in the further favorable course of BL

. A high degree of correlation was revealed between treatment started in the first month of the disease and recovery. Thus, in BL, the prognosis clearly correlates not only with optimal antibacterial therapy, but also with the early timing of its initiation [12]. In relation to rheumatology, this means that timely adequate treatment of local skin infection is essentially the primary prevention of the development of arthritis and other systemic manifestations of BL.

In accordance with the recommendations of the Infectious Diseases Society of America [13], the first-line drugs for the treatment of early (local and disseminated) stages of BL are doxycycline

(100 mg twice daily orally) or
amoxicillin
(500 mg three times daily orally) given for 14–21 days. According to prospective studies, these drugs have demonstrated similar effectiveness in the treatment of CME and associated symptoms of LD in the absence of neurological manifestations and/or third degree atrioventricular block. Cefuroxime-axetil, which is similar in effectiveness to doxycycline in the treatment of CME, is considered an alternative drug for this category of patients due to its high cost.

Of particular interest is a comparative randomized study of 11 treatment regimens performed in Russia in a large group of patients with CME. Significantly better results were obtained with the use of doxycycline (0.2 g per day per os for 14 days) compared with penicillin (2 million units per day intramuscularly for 10–14 days) and tetracycline (1.2 g per day for within 14 days). The use of cefuroxime at a dose of 1 g per day gave results similar to those of doxycycline treatment. The optimal treatment result was observed when antibiotics were prescribed in the first 5 days of illness, and the duration of the course of antibiotic therapy was at least 14 days [14].

With the development of Lyme arthritis, in accordance with American recommendations, the administration of doxycycline or amoxicillin in the above doses for 28 days is indicated. If, after a course of treatment, a relapse of arthritis develops, it is advisable to prescribe another antibiotic for oral administration or use ceftriaxone for 2–4 weeks (but not earlier than 3–4 months from the end of the previous course of antibacterial therapy).

The results of a special epidemiological experiment conducted in Russia on a large group of patients deserve undoubted attention. The high effectiveness of short-term antibacterial therapy has been established according to the indications of rapid diagnosis of borrelia in the intestines of ticks, as a method of preventing tick-borne borreliosis. The use of doxycycline 0.2 g per day orally for 3–5 days after a tick bite reduced the incidence by 11 times [15].

Doxycycline - a basic antirheumatic drug?

For rheumatologists, interest in antibacterial drugs is by no means limited to their direct antimicrobial effect. Equally worthy of attention are the anti-inflammatory and immunomodulatory effects that a number of antimicrobial and antiparasitic agents have revealed in numerous experimental and clinical studies. These include drugs of the tetracycline group.

Currently, there is quite strong evidence indicating the advisability of using tetracyclines, including doxycycline, as basic agents in the treatment of RD, in particular rheumatoid arthritis and osteoarthritis (Table 3). One of the factors determining the anti-inflammatory activity of tetracyclines is the ability of these drugs to inhibit matrix metalloproteinases - specific zinc-dependent enzymes (collagenases, gelatinases, stromelysins, etc.) that play an important role in the degradation of macromolecules of the extracellular matrix of connective tissue. It is assumed that in rheumatoid arthritis and osteoarthritis there are local imbalances between the production of activated forms of metalloproteinases and their tissue inhibitors.

There are reports in the literature of
the successful use of doxycycline in rheumatological patients
. Use of this drug at a dose of 150 mg/day for 3 months. in patients with rheumatoid arthritis led to clear positive dynamics in a number of indicators (joint count, pain intensity determined by visual analogue scale, decreased collagenase activity in saliva, various psychopathological parameters) [16]. In a 6-month pilot study of 23 patients with rheumatoid arthritis, the effectiveness of doxycycline was comparable to that of methotrexate [17]. The results obtained deserve serious attention and clearly indicate the promise of work in this direction.

On the other hand, the proven fact of inhibition of matrix metalloproteinases and a pronounced increase in the penetration of doxycycline into cartilage tissue, the subchondral bone layer and the synovium in the presence of flurbiprofen led to the conclusion that it is advisable to conduct clinical trials of doxycycline for osteoarthritis with an expected treatment period of 12 to 18 months. [18].

Thus, doxycycline still remains one of the most interesting and promising antibiotics

. Further use of this drug will, in all likelihood, expand the range of indications for its use both in rheumatology and in other areas of clinical medicine.

A complete list of references can be found on the website https://www.rmj.ru
References:
1. Joshi M., Miller DQ Doxycycline revisited. Arch. Intern. Med. 1997; 157:1421–1428.

2. Navashin S.M., Navashin P.S. Tetracyclines in the treatment of bacterial infections. Antibiotics and chemotherapy. 1993; 38(1): 53 – 62.

3. Division of STD Prevention. Sexually Transmitted Disease Surveillance, 1999. Atlanta, 2000, Sept.

4. CDC. 1998 Guidelines for treatment of sexually transmitted diseases. MMWR. 1998; 47: 1 – 117.

5. Kovalev Yu.N., Ilyin N.I. Reiter's disease. Chelyabinsk, 1993.

6. Sidelnikova S.M., Agababova E.R., Stysin E.A., Martynova V.R., Shcherbakova N.I., Bagdasarov A.B. Clinical symptoms and some issues of treatment of Reiter's disease. Ter. archive. 1978; 6: 99 – 103.

7. Khamraev A.A. The effect of antibiotics on clinical symptoms and indicators of chlamydial infection in urogenic Reiter's disease. Author's abstract. diss. Ph.D. honey. Sci. M., 1990.

8. Lauhio A., Leirisalo–Repo M., Lahdevirta J., Saikku P., Repo H. Double–blind, placebo–controlled study of three–month treatment with lymecycline in reactive arthritis, with special reference to Chlamydia arthritis. Arthritis Rheum. 1991; 34: 6 – 14.

9. Wollenhaupt J., Hammer M., Pott HG, Zeidler H. A double-blind placebo-controlled comparison of 2 weeks versus 4 months treatment with doxycycline in chlamydia-induced arhritis. Arthritis Rheum. 1997; 40: S.143.

10. Sieper J., Braun J. Treatment of reactive arthritis with antibiotics. Br. J. Rheumatol. 1998; 37 (7): 717 – 720.

11. Ananyeva L.P. Lyme disease is a multidisciplinary problem. Selected lectures on clinical rheumatology. Ed. V.A., Nasonova, N.V. Bunchuk. M., Medicine, 2001: 148 – 158.

12. Barskova V.G. Rheumatic syndromes in various outcomes of Lyme disease. Author's abstract. diss... cand. honey. Sci. M., 1995.

13. Wormser GP, Nadelman RB, Dattwyller RJ, Dennis DT, Shapiro ED, Steere AC et al. Practice guidelines for the treatment of Lime disease. Clin. Infect. Dis. 2000; 31 (Suppl.1): 1 – 14.

14. Laikovskaya E.E. Study of the effectiveness of antibacterial therapy at the early stage of Lyme borreliosis (Lyme disease) with long-term prospective observation. Author's abstract. diss. Ph.D. honey. Sci. M., 1997.

15. Moskvitina G.E. Emergency prevention of ixodid tick-borne borreliosis based on indication of the pathogen in attached ticks. Author's abstract. diss. Ph.D. biol. Sci. M., 1996.

16. Nordstrom D., Lindy O., Lauhio A., Sorsa T., Santavirta S., Kontinen GT Anti–collagenolytic mechanism of action of doxycycline treatment in rheumatoid arthritis. Rheumatol. Int. 1998; 17(5): 175 – 180.

17. Sreekanth WR, Handa R., Wali JP, Aggarwal P., Dwivedi SN Doxycycline in the treatment of rheumatoid arthritis – a pilot study. J. Assoc. Physicians India. 2000; 48(8): 804 – 807.

18. Ryan ME, Greenwald RA, Golub LM Potential of tetracyclines to modify cartilage breakdown in osteoarthritis. Curr. Opin. Rheumatol. 1996; 8: 238 – 247.

Doxycycline or Amoxicillin - which is better, what is the difference

Manufacturer: HEMOFARM (Serbia)
Release form: capsules

Active ingredient: amoxicillin

Both drugs are active against a number of strains of bacterial pathogens. The effect of the Doxycycline analogue in capsules on the body is milder. It will be the best because:

• the drug is approved for use by pregnant women and during lactation;
• can be prescribed to children, including newborns;
• does not affect beneficial intestinal microflora;
• has a quick effect and has a minimum of complications.

In case of aggressive infections and pathological processes affecting the genitourinary system, with intolerance to penicillin antibiotics, the advantage will remain with Doxycycline.

Ciprofloxacin

Produce

l: SYNTHESIS (Russia)

Release form: tablets

Active ingredient: ciprofloxacin

Ciprofloxacin, an analogue of Doxycycline in tablets, is an antimicrobial agent from the group of fluoroquinolones. Has a wide spectrum of action. The antibiotic disrupts DNA production, which leads to inhibition of bacterial growth and reproduction.

Under the influence of the drug, structural changes in bacteria occur, which entails their death.

Ceftriaxone

Manufacturer: ALKEM LABORATORIS (India)
Release form: powder for the preparation of a solution for intramuscular and intravenous administration

Active ingredient: ceftriaxone

The Doxycycline analogue is a 3rd generation cephalosporin antibiotic with a broad spectrum of action. Ceftriaxone has a bactericidal effect on the cell wall of the pathogen, inhibiting its synthesis.

The medication is active against a number of strains of aerobes and anaerobes. The antibiotic has the ability to quickly penetrate the tissues and fluids of the body.

Lincomycin

Manufacturer: SYNTHEZ (Russia)
Release form: capsules, solution for IM and IV administration

Active ingredient: lincomycin

Lincomycin is an analogue of Doxycycline and is an antibiotic of the lincosamide group. The drug inhibits protein synthesis in the cellular structure of microorganisms.

The active action of the antibiotic extends mainly to a number of strains of aerobic gram-positive bacteria. The dosage of the medication determines the bacteriostatic or bactericidal effect.

Manufacturer of Doxycycline®

The semi-synthetic antibiotic was discovered in the 60s of the last century. The synthesis was carried out by the American company Pfizer®, which for the first time released a new drug onto the pharmaceutical market, giving it the name Vibramycin®. Currently, other producing countries are on the market: Russia, Germany, Jordan, Cyprus, Canada, the Netherlands, etc.

All of them take as a basis the main component of the drug - Doxycycline®, and by adding auxiliary components they form the final product. After confirming its safety, the antibiotic is supplied to the markets of countries that cooperate with the companies.

Tsiprolet

Manufacturer: DOCTOR REDDIS (India)
Release form: tablets, injection solution

Active ingredient: ciprofloxacin

Tsiprolet is an antibacterial drug from the group of fluoroquinolones with a broad spectrum of action. This substitute for Doxycycline in tablets affects the synthesis of bacterial DNA, which leads to a slowdown in the growth and reproduction of pathogenic microorganisms.

The analog Tsiprolet is active not only against pathogens of anaerobic infections, but also against Trichomonas.

A properly selected and prescribed analogue of Doxycycline will allow you to stop the inflammatory process in the shortest possible time and prevent serious complications.

Nosological classification (ICD-10)

• A21 Tularemia
• A23.9 Brucellosis, unspecified
• A49.3 Mycoplasma infection, unspecified
• A53.9 Syphilis, unspecified
• A54 Gonococcal infection
• A56 Other chlamydial sexually transmitted diseases
• A70-A74 Other diseases caused by chlamydia
• A75-A79 Rickettsial diseases
• J06 Acute upper respiratory tract infections of multiple and unspecified localization
• J18 Pneumonia without specifying the pathogen
• J22 Acute respiratory infection of the lower respiratory tract, unspecified
• J30 Vasomotor and allergic rhinitis
• J39.9 Upper respiratory tract disease, unspecified
• J40 Bronchitis, not specified as acute or chronic
• J42 Chronic bronchitis, unspecified
• J44.9 Chronic obstructive pulmonary disease, unspecified
• M60.0 Infectious myositis
• M65.0 Tendon sheath abscess
• M65.1 Other infectious tenosynovitis
• M71.0 Abscess of bursa
• M71.1 Other infectious bursitis
• N39.0 Urinary tract infection without established location
• N49 Inflammatory diseases of the male genital organs, not elsewhere classified
• N73.9 Inflammatory diseases of the female pelvic organs, unspecified
• N74.2 Inflammatory diseases of the female pelvic organs caused by syphilis (A51.4+, A52.7+)
• N74.3 Gonococcal inflammatory diseases of the female pelvic organs (A54.2+)
• N74.4 Inflammatory diseases of the female pelvic organs caused by chlamydia (A56.1+)

Answers on questions

Is doxycycline an antibiotic or not?

Doxycycline is a broad-spectrum antibiotic.

Is Doxycycline available by prescription or not?

The medication is dispensed only with a doctor's prescription.

Is it okay to take doxycycline with alcohol or not?

Combining the drug with alcohol is not recommended, as it develops a strong side effect on the liver. The toxic effect of alcohol and Doxycycline on the organ provokes the development of structural and functional disorders.