which one of the following tetracycline has the longest duration of action?
- Doxycline (Vibramycin)***
- Tetracycline (Achromycin)
- Minocycline (Minocin)
- Oxytetracycline (Terramycin)
- Demeclocycline (Dclomycin).
Doxycycline:
Broad spectrum antibioticPHARMACEUTICAL FORM AND FORMULATION:
Each CAPSULE contains:
Doxycycline hyclate equivalent to .... 50 and 100 mgof doxycycline
THERAPEUTIC INDICATIONS:
DOXICICLINE is indicated for the treatment of the following infections: spotted rocky mountain fever, typhoid fever, Q fever, pustular rash from ricketsias and rocky mountain fever from ricketsias, respiratory tract infections caused by Mycoplasma pneumoniae. (PPLO, Eaton agent lymphogranuloma venereum caused by Chlamydia trachomatis).Psittacosis (ornitosis) caused by Chlamydia psittacci; trachoma caused by Chlamydia trachomatis, although the infectious agent is not always eliminated, judging by immunofluorescence; inclusion conjunctivitis caused by Chlamydia trachomatis; uncomplicated urethral, endocervical or rectal infection in adults, caused by Chlamydia trachomatis; non-gonococcal urethritis caused by Ureaplasma urealyticum; Recurrent fever caused by Borrelia recurrentis.
DOXICICLINE is also indicated for the treatment of infections caused by the following gram-negative microorganisms: chancroid caused by Haemophilus ducreyi, pest due to Yersinia pestis (formerly Pasteurella pestis), tularemia due to Francisella tularensis (formerly Pasteurella tularensis), cholera caused by Vibrio cholerae (Vibrio cholerae ( formerly Vibrio comma), Campylobacter infections in fetuses caused by Campylobacter fetus (formerly Vibrio fetus), brucellosis caused by Brucella species (along with streptomycin), bartonellosis caused by Bartonella bacilliformis, inguinal granuloma caused by Calymmatobacterium granulomatis.
As it has been shown that many of the strains of the following groups of microorganisms are resistant to DOXICICLINE, cultures and susceptibility tests are recommended.
DOXICICLINE is indicated for the treatment of infections caused by the following gram-negative microorganisms when the bacteriological test indicates adequate susceptibility to the drug: Escherichia coli, Enterobacter aerogenes (formerly Aerobacter aerogenes), Shigella sp, Acinetobacter sp (formerly Mima sp and Herellea sp), infections of the respiratory tract caused by Haemophilus influenzae, respiratory tract and urinary tract infections caused by Klebsiella sp.
DOXICICLINE is indicated for the treatment of infections caused by the following gram-positive microorganisms when the bacteriological test indicates adequate susceptibility to the drug: upper respiratory infections caused by Streptococcus pneumoniae (formerly Diplococcus pneumoniae), skin infections and skin structures caused by Staphylococcus aureus
DOXICICLINE is not the drug of choice for the treatment of any type of infection caused by staphylococci, Streptococcus sp.
It has been found that up to 44% of Streptococcus pyogenes and 74% of Streptococcus faecalis strains are resistant to tetracyclines.
Therefore, tetracyclines should not be used for streptococcal disease, unless the microorganism has been shown to be sensitive.
For infections in the upper respiratory tract caused by group A beta-hemolytic streptococci, penicillin is the usual drug of choice, including rheumatic fever prophylaxis.
When penicillin is contraindicated, DOXICICLINE is an alternative drug for the treatment of the following infections: uncomplicated gonorrhea caused by Neisseria gonorrhoeae, infections caused by Neisseria meningitidis, syphilis caused by Treponema pallidum, lesions caused by Treponema pertenue, listeriosis caused by Listeria monocyte , anthrax caused by Bacillus anthracis, Vincent's infection caused by Fusobacterium fusiforme, actinomycosis caused by Actinomyces israelii, and other infections caused by Actinomyces species, infections caused by Clostridium sp.
In acute intestinal amebiasis, DOXICICLINE can be a useful adjuvant for amebicides.
In severe acne, DOXYCYCLINE can be a useful adjunctive therapy.
Prophylaxis:
DOXICICLINE is indicated for the prophylaxis of malaria by Plasmodium falciparum in tourists who remain for a short time
Other indications:
DOXICICLINE is used alone or as an adjuvant in the treatment of epididymitis, infertility possibly due to T-mycoplasma, anicteric leptospirosis and stage I of Lyme disease. It is also used in proctitis, proctocolitis, enteritis and recurrent periodontitis. In addition, DOXICICLINE is also used as a sclerosing agent for pleural effusion therapy, prophylactically in colon surgery and as an adjuvant in the treatment of the Mycobacterium fortuitum complex.
CONTRAINDICATIONS:
The drug is contraindicated in people with known hypersensitivity to any of the tetracyclines.
GENERAL PRECAUTIONS:
- The use of tetracyclines may increase the incidence of vaginal candidiasis. DOXICICLINE should be used with caution in patients with a history of predisposition to oral candidiasis.
- The safety and efficacy of the medication for treatment has not been established.
- to periodontitis in patients with coexisting oral candidiasis.
- If a superinfection occurs, appropriate measures should be taken for its treatment.
RESTRICTIONS OF USE DURING PREGNANCY AND BREASTFEEDING:
Risk category D:
It should not be administered in pregnant women or with the possibility of pregnancy or in children under 8 years. The drug may cause fetal toxicity when administered to pregnant women; however, the potential benefits of its use may be acceptable under certain conditions despite the risks to the fetus, and must be administered under strict medical control.
Due to the potential risk to infants, a decision should be made about discontinuing treatment or breastfeeding, taking into consideration the importance of the drug to the mother. The effect of tetracyclines on labor and delivery is not known.
The use of tetracyclines during tooth development (last half of pregnancy, infants and children up to the age of 8 years) can cause permanent discoloration of the teeth.
SECONDARY AND ADVERSE REACTIONS:
Because virtually DOXICICLINE is completely absorbed, side effects in the small intestine, particularly diarrhea, are rare.
The following adverse reactions have been observed in patients receiving tetracyclines:
Gastrointestinal:
Anorexia, nausea, vomiting, diarrhea, glossitis, dysphagia, enterocolitis and inflammatory lesions (with excessive growth of moniliasis) in the anogenital region. Very rarely hepatotoxicity has been reported. These reactions are caused by both oral and parenteral administration of tetracyclines. Rare cases of esophagitis and esophageal ulcerations have been reported in patients receiving capsules and tablets of drugs of the tetracycline class. Most of these patients took the medications immediately before bedtime.
Skin:
Maculopapular and erythematous rashes. Exfoliative dermatitis has been reported, but it is very rare. The photosensitivity was discussed above.
Renal toxicity:
Increases in BUN levels, apparently dose-related, have been reported.
Hypersensitivity reactions:
Hives, angioneurotic adema, anaphylaxis, anaphylactoid purpura, serum sickness, pericarditis and exacerbation of systemic lupus erythematosus.
Blood:
Hemolytic anemia, thrombocytopenia, neutropenia and eosinophilia have been reported with tetracyclines.
Others:
Swelling of the fontanelles in infants and intracranial hypertension in adults. When administered for prolonged periods, it has been reported that tetracyclines produce brown-black microscopic discoloration of the thyroid gland. It is not known that abnormalities of thyroid function occur.
DRUG INTERACTIONS AND OTHER GENDER:
As tetracyclines have been shown to decrease the activity of prothrombin in plasma, patients taking anticoagulants may require a decrease in their dose of anticoagulant. Since bacteriostatic drugs may interfere with the bactericidal action of penicillin, it is recommended not to administer tetracyclines together with penicillin. Tetracycline absorption decreases with antacids that contain aluminum, calcium or magnesium, as well as iron-containing preparations. Tetracycline absorption is decreased by bismuth subsalicylate.
Barbiturates, carbamazepine and phenytoin decrease the half-life of DOXICICLINE. It has been reported that the combined use of tetracycline and methoxyflurane results in fatal renal toxicity.
Joint use of tetracycline may decrease the effectiveness of oral contraceptives. The antianabolic action of tetracyclines can cause an increase in BUN levels. Studies conducted to date indicate that this does not occur with the use of DOXICICLINE in patients with renal impairment.
Photosensitivity manifested by an exaggerated sunburn reaction has been observed in some individuals taking tetracyclines. Patients who are exposed to direct or ultraviolet light should be advised that this reaction may occur with tetracyclines, and treatment should be suspended at the first evidence of cutaneous erythema.
Some brands of formulations contain sodium metabisulfite, a sulfi-
This may cause allergic reactions, including life-threatening anaphylactic symptoms, or less severe asthmatic episodes in certain susceptible people.
The overall prevalence of sulphite sensitivity in the general population is unknown, and is probably low. Sulfite sensitivity is seen more frequently in asthmatic than non-asthmatic people.
In venereal disease, when coexistence of syphilis is suspected, a dark field test should be performed before starting treatment and repeat blood serology every month for at least 4 months. In long-term therapy, periodic laboratory evaluations of organ systems, including hematopoietic, renal and hepatic, should be performed.
PRECAUTIONS IN RELATION TO EFFECTS OF CARCINOGENESIS, MUTAGENESIS, TERATOGENESIS AND ON FERTILITY:
No long-term studies have been conducted in animals to assess the possible carcinogenicity of DOXICICLINE. However, there has been evidence of oncogenic activity in studies with rats with related antibiotics, oxytetracycline (adrenal and pituitary tumors) and minocycline (thyroid tumors). Similarly, although no DOXICICLINE mutagenicity studies have been conducted, positive results have been reported in in vitro mammalian cell studies with related antibiotics (tetracycline and oxytetracycline). DOXICICLINE administered orally at doses as high as 250 mg / kg / day has no apparent effect on fertility in female rats. It has not been studied in male fertility.
DOSAGE AND ROUTE OF ADMINISTRATION:
The usual dose and frequency of administration of DOXICICLINE differs from other tetracyclines. If the recommended doses are exceeded, an increased incidence of side effects may result.
Adults:
The usual dose of DOXICICLINE is 200 mg on the first day of treatment (given as 100 mg every 12 hours or 50 mg every 6 hours) followed by a maintenance dose of 100 mg / day. The maintenance dose can be administered as one dose per day or as 50 mg every 12 hours.
In the management of more severe infections (particularly chronic urinary tract infections), 100 mg every 12 hours is recommended.
Children over 8 years:
The recommended dosing schedule for children weighing 45.3 kg, or less is 4.41 mg / kg body weight, divided into two doses on the first day of treatment, followed by 2.2 mg / kg body weight administered on subsequent days. as a single dose or divided into two doses. For more severe infections up to 4.41 mg / kg body weight can be used. For children weighing more than 43.5 kg, the usual dose for adults should be used.
Therapeutic serum antibacterial activity usually persists for 24 hours after the recommended dose.
When used in streptococcal infections, therapy should be continued for 10 days. The administration of adequate amounts of fluids along with the capsules and tablets of the tetracycline class is recommended to wash the drugs and reduce the risk of esophageal irritation and ulceration. If gastric irritation occurs, it is recommended to administer DOXICICLINE with food or milk.
The absorption of DOXICICLINE is not greatly influenced by the simultaneous ingestion of food or milk.
Antacids containing aluminum, calcium or magnesium, sodium bicarbonate and iron-containing preparations should not be administered in patients taking oral tetracyclines.
Studies to date have indicated that the administration of DOXICICLINE, at the usual recommended doses, does not produce excessive accumulation of the antibiotic in patients with renal impairment.
Uncomplicated gonococcal infections in adults (except anorectal infections in men):
100 mg orally twice daily for 7 days. As an alternative single dose administer 300 mg followed in 1 hour for a second dose of 300 mg.
When required, the dose can be administered with food, including milk or carbonated beverages.
Uncomplicated urethral, endocervical or rectal infection in adults, caused by Chlamydia trachomatis: 100 mg orally twice daily, for at least 7 days.
Non-gonococcal urethritis (NGU) caused by C. trachomatis or U. urealyticum: 100 mg orally 2 times a day, at least for 7 days.
Early syphilis:
Patients who are allergic to penicillin should be treated with DOXICICLINE, 100 mg orally twice daily for 2 weeks.
Syphilis lasting more than one year:
Patients who are allergic to penicillin should be treated with DOXICICLINE 100 mg orally twice daily for 4 weeks.
Alternatively, in primary and secondary syphilis:
300 mg daily in divided doses for at least 10 days.
Acute epididymoorchitis caused by N. gonorrhoeae:
100 mg orally twice a day, at least for 10 days.
When used in infections caused by streptococci, therapy should be continued for 10 days.
The administration of adequate amounts of fluids along with the capsules and tablets of the tetracycline class drugs is recommended to wash the drugs and decrease the risk of esophageal irritation and ulceration.
If gastric irritation occurs, DOXICICLINE can be administered with food.
It has been shown that eating a high-fat meal slows time to reach maximum plasma concentrations by an average of 1 hour and 20 minutes.
However, in the same study, food increased the average maximum concentration by 7.5% and area under the curve by 5.7%.
For malaria prophylaxis:
Adults:
The recommended doses are 100 mg / day.
For children over 8 years:
The recommended dose is 2 mg / kg administered once a day until the adult dose is reached.
Prophylaxis should be started 1 to 2 days before traveling to an endemic area for malaria. Prophylaxis should be continued daily during the stay in the endemic area and for 4 weeks after travelers leave the endemic area.
MANIFESTATIONS AND MANAGEMENT OF OVERDOSE OR ACCIDENTAL INGESTION:
In case of intoxication, discontinue the medication, treat symptomatically and institute support measures.
Dialysis does not alter serum half-life, therefore, it would not be beneficial for the treatment of overdose cases.
RECOMMENDATIONS ON STORAGE:
Store at room temperature at no more than 30 ° C and in a dry place.
What is long acting antibiotic?
Long-Acting Antibiotics.
These usually are called Drugname LA. The LA stands for Long Acting. What this simply means is that the antibiotic is slowly released into the body over a longer period before it needs to be re-injected / re-administered.
What is tetracycline and doxycycline?
Tetracyclines are broad spectrum antibiotics often used to treat skin, chest, urethral, and pelvic infections. Doxycycline is indicated in a wide range of infections including syphilis, Lyme disease, Q fever, Rocky Mountain spotted fever, and plague. It is also widely used for malaria prophylaxis.
Which tetracycline has longest half life?
Doxycycline remains the preferred tetracycline agent for most indications. Doxycycline has a long half-life, which makes convenient twice-a-day dosing possible.
What is the duration of treatment for vibramycin?
The therapeutic antibacterial serum activity will usually persist for 24 hours following recommended dosage. When used in streptococcal infections, therapy should be continued for 10 days.
How long does vibramycin take to work?
For most infections, you should start to feel better within a few days of using doxycycline. Tell your physician if you don't feel better after three days or if you feel worse at any time. It's important that you keep taking this medicine for as long as your doctor tells you to.
Is vibramycin a tetracycline?
Vibramycin Oral (doxycycline) is a tetracycline antibiotic used to treat many different bacterial infections, such as urinary tract infections, acne, gonorrhea, and chlamydia, periodontitis (gum disease), and others.
What is long acting tetracycline?
Oxytetracycline and chlortetracycline are classified as short-acting, and doxycycline and minocycline are classified as long- acting. The second generation (long-acting) tetracyclines penetrate tissues particu- larly well because of their lipid solubility.
What is the duration of treatment for doxycycline?
Adults and children weighing 45 kilograms (kg) or more—100 milligrams (mg) two times a day (taken every 12 hours) for 60 days. Children weighing less than 45 kg—Dose is based on body weight and must be determined by your doctor. The dose is usually 2.2 mg per kg of body weight per day, two times a day for 60 days.
Which is more effective doxycycline or tetracycline?
Both antibiotics are effective for Lyme disease associated with erythema migrans9. However, doxycycline is preferred to tetracycline, particularly in patients with early disseminated disease. Doxycycline has better microbiologic activity and reaches higher cerebrospinal fluid concentrations.
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