Doxycycline in Survival Settings

(Note: This is a companion article for our YouTube video on the antbiotic Doxycycline.)

Antibiotics are a wise addition to any survival medicine cabinet. Many infections that are considered minor today could become life-threatening without access to these microbe-killing drugs. When, however, do you use them? Which ones are appropriate for the illness you’re treating? Are there other considerations that must be taken into account?  This article is part of a continuing series on drugs that will help the caregiver in a major disaster that takes away access to modern medical facilities and personnel.

 
One of the antibiotics on the World Health Organization’s List of Essential Medicines is Doxycycline. Doxycycline is a synthetic (man-made) antibiotic in the tetracycline family, the first member of which was discovered in the late 1940s.. It is effective against a wide variety of bacteria, such as Hemophilus influenzae, Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydia, gonorrhoea, and many others. Doxycycline is marketed under various names, including Vibramycin and Vibra-Tabs. Its veterinary equivalent is the popular avian drug “Bird-Biotic”.

 
Doxycycline, as it is related to tetracycline, is acceptable in patients allergic to Penicillin. It works by inhibiting the production of bacterial proteins necessary for their reproduction.

 
Doxycycline is an extraordinarily versatile drug. Indications for its usage include the following:

 
• E. Coli, Shigella and Enterobacter infections (diarrheal disease)
• Chlamydia and Gonorrhea (sexually transmitted diseases)
• Lyme disease
• Rocky Mountain spotted fever
• Anthrax
• Cholera
• Plague (yes, THE plague)
• Gum disease (severe gingivitis, periodontitis)
• Folliculitis (boils)
• Acne and other inflammatory skin diseases, such as hidradenitis (seen in armpits and groins)
• Some lower respiratory tract (pneumonia) and urinary tract infections
• Upper respiratory infections caused by Strep
• Methicillin-resistant Staph (MRSA) infections
• Malaria (prevention)
• Some parasitic worm infections (doesn’t kill the worm directly, but kills bacteria in their gut needed to survive)

In the case of Rocky Mountain spotted fever, doxycycline is indicated even for use in children. Otherwise, doxycycline is not meant for those under the age of eight years due to its tendency to cause, among other things, tooth discoloration. It has not been approved for use during pregnancy and passes into the milk of breast-feeding mothers. Of course, avoid Doxycycline if you’re allergic to any medications in the tetracycline family.

 
The recommended Doxycycline dosage for most types of bacterial infections in adults is 100 mg to 200 mg per day for 7-14 days. For chronic (long-term) or more serious infections, treatment can be carried out for a longer time. Children will receive 1-2mg per pound of body weight per day. For Anthrax, the treatment should be prolonged to 60 days. As prevention against malaria, adults should use 100mg per day. Doxycycline should be taken with a full glass of water.

 
You may have heard that drugs in the tetracycline family have been reported to cause kidney toxicity. Tetracycline incited considerable interest due to this in the early 1960s, shortly after its introduction. People, particularly children, developed kidney dysfunction after receiving outdated drugs.
In these cases, the cause was found to be due to a degradation product of the drug called anhydro-4-epitetracycline. This no longer seems to be an issue after a new formulation substituting citric acid for lactose, at least according to a 1991 report from the World Health Organization. Kidney issues are rare in patients who take doxycycline as long as they started out with normal renal function.

 
In a survival setting, you’ll most likely be using doxycycline to deal with infections causing diarrheal disease. Although antibiotics may be warranted, always start with hydration and symptomatic relief. Prolonged diarrhea lasting more than 3 days, high fevers, and bleeding are good reasons to consider their use. The risk is that one of the most common side effects of antibiotics is….diarrhea!

Joe Alton, MD