TY  - JOUR
T1  - DOxycycline re-revisited
AU  - Cunha BA
Y1  - 1999/05/10
N1  - 
JO  - Archives of Internal Medicine
SP  - 1006
EP  - 1006
VL  - 159
IS  - 9
N2  - 
It is true that because of its lipid solubility characteristics and long serum half-life, optimally doxycycline should initially be administered as a high dose (200 mg intravenously [IV] or orally every 12 hours) to saturate the serum and tissue compartments for 72 hours before completing the course of therapy with the conventional dose of, 100 mg IV or orally every 12 hours. Tice suggests a "loading dose" of doxycycline at the start of therapy. However, although a single loading dose is sufficient with many other antibiotics, eg, aminoglycosides, multiple doses are needed to properly "load" the patient receiving doxycycline. For the past 20 years at Winthrop-University Hospital, we have administered doxycycline to ill patients with an initial loading dose of 200 mg IV every 12 hours for the initial 72 hours, then the dose is reduced to 100 mg every 12 hours, or 200 mg every 24 hours for the duration of therapy. Because it takes approximately 5 serum half-lives of a drug to achieve steady-state concentrations, the initial 72-hour loading regimen of doxycycline is essential for optimal rapid therapeutic effects. If doxycycline is administered in the usually recommended dosage, ie, 100 mg IV or orally every 12 hours, it will be approximately 3 to 5 days before the patient achieves steady-state saturation and improvement. For this reason, clinicians administering doxycycline without a proper loading regimen for the first 72 hours have been dissatisfied with the response of doxycycline after 3 to 5 days of treatment and in some cases have switched to alternate antibiotics, not appreciating the fact that the patient received little/no drug until after 5 days of conventional dosing.

SN  - 0003-9926
M3  - doi: 
UR  - http://dx.doi.org/
ER  -