We report two cases of murine typhus diagnosed by indirect immunofluorescent test. The patients showed cardinal symptoms and signs such as fever and chill, general myalgia, intractable headache and typical rash. Laboratory values and histopathologic findings were compatible with murine typhus. The oral administration of doxycycline improved dramatically the clinical manifestations of the two CCLSPS.
Administration, Oral ; Doxycycline ; Exanthema ; Fever ; Headache Disorders ; Humans ; Myalgia ; Typhus, Endemic Flea-Borne*

Pancytopaenia is a rare clinical presentation of severe leptospirosis. We would like to report a case of severe leptospirosis that progressed to pancytopaenia despite initial penicillin therapy. The patient needed a second course of antibiotic with doxycycline to improve his persistent symptoms and cytopaenia. Persistent pancytopaenia in severe leptospirosis and its management were reviewed.
Doxycycline/administration & dosage ; Drug Therapy, Combination ; Leptospirosis/*complications ; Leptospirosis/drug therapy ; Pancytopenia/drug therapy ; Pancytopenia/*etiology ; Penicillins/administration & dosage

BACKGROUND: The intrapleural instillation of tetracycline for pleural sclerosis had been most commonly used in patients with symptomatic malignant pleural effusion or recurrent pneumothorax for a long time. Unfortunately, at a time of expanding use of this agent, the production of injectable tetracycline hydrochloride used for pleurodesis was discontinued by its sole manufacturer in mid-1991 because the manufacturer was unable to meet US Food and Drug Administration purity standards. So we performed a preliminary study of doxycycline, as a alternative pleural sclerosant on rabbit pleura and compared its efficacy with that of tetracycline. METHOD: Eighteen New Zealand white rabbits weighing 2 to 3kg(mean 2.6kg) were divided into three groups. In each groups, one tetracycline(20 mg/ml/kg) and two doxycycline solutions(7 mg/ml/kg and 20 mg/ml/kg) instillated into the right pleural space through an 18-gauge angiocath with care to prevent pneumothorax. All rabbits were sacrificed after 28 days. RESULTS: 1) In the group of tetracycline 20 mg/ml/kg(six rabbits), five rabbits showed partial pleural symphysis with several fibrous bands, and one rabbit died on 22th day. 2) In the group of doxycycline 7 mg/ml/kg(six rabbits), three rabbits showed partial pleural symphysis and the other three rabbits showed complete pleural symphysis without necrosis of underlying parenchymal lung tissue. 3) In the group of doxycycline 20 mg/ml/kg(six rabbits), two rabbits showed complete pleural symphysis without lung necrosis, another two rabbits showed complete pleural symphysis with lung necrosis, and the other two rabbits died on 4th and 13th day, respectively. CONCLUSION: We concluded that doxycycline is a highly effective sclerosing agent having stronger pleurodesis effect with that of tetracycline by dose base and its optimal dosage was considered as 7 mg/ml/kg with minimal complications.
Doxycycline* ; Humans ; Lung ; Necrosis ; Pleura ; Pleural Effusion, Malignant ; Pleurodesis* ; Pneumothorax ; Rabbits ; Sclerosis ; Tetracycline ; United States Food and Drug Administration

Administration, Oral ; Anti-Bacterial Agents ; administration & dosage ; Brimonidine Tartrate ; administration & dosage ; Diagnosis, Differential ; Doxycycline ; administration & dosage ; Face ; physiopathology ; Female ; Humans ; Inflammation ; Middle Aged ; Rosacea ; diagnosis ; drug therapy ; Singapore ; Steroids ; administration & dosage ; Treatment Outcome

A bioavailability and pharmacokinetics study of doxycycline was carried out on 30 healthy ostriches after a single intravenous (IV), intramuscular (IM) and oral dose of 15 mg/kg body weight. The plasma doxycycline concentration was determined by HPLC/UV at 0 (pretreatment), 0.08, 0.25, 0.5 1, 2, 4, 6, 8, 12, 24 and 48 h after administration. The plasma concentration-time curves were examined using non-compartmental methods based on the statistical moment theory for only the higher dose. After IV administration, the elimination half-life (t(1/2beta)), mean residence time (MRT), volume of distribution at the steady-state (V(ss)), volume of distribution (Vd(area)) and total body clearance (Cl(B)) were 7.67 +/- 0.62 h, 6.68 +/- 0.86 h, 0.86 +/- 0.16 l/kg, 1.67 +/- 0.52 l/kg and 2.51 +/- 0.63 ml/min/kg, respectively. After IM and oral dosing, the mean peak plasma concentrations (C(max)) were 1.34 +/- 0.33 and 0.30 +/- 0.04 microgram/ml, respectively, which were achieved at a postadministration time (t(max)) of 0.75 +/- 0.18, 3.03 +/- 0.48 h, respectively. The t(1/2beta), Vd(area) and Cl(B) after IM administration were 25.02 +/- 3.98 h, 23.99 +/- 3.4 l/kg and 12.14 +/- 1.71 ml/min/kg, respectively and 19.25 +/- 2.53 h, 61.49 +/- 7 l/kg and 40.19 +/- 3.79 ml/min/kg after oral administration, respectively. The absolute bioavailability (F) of doxycycline was 5.03 and 17.52% after oral and IM administration, respectively. These results show that the dose data from other animals particularly mammals cannot be extrapolated to ostriches. Therefore, based on these results along with those reported in the literature, further studies on the pharmacokinetic/pharmacodynamic, in vitro minimum inhibitory concentration values and clinical applications of doxycycline in ostriches are required.
Administration, Oral ; Animals ; Anti-Bacterial Agents/administration & dosage/blood/*pharmacokinetics ; Area Under Curve ; Biological Availability ; Dose-Response Relationship, Drug ; Doxycycline/administration & dosage/blood/*pharmacokinetics ; Half-Life ; Injections, Intramuscular/veterinary ; Injections, Intravenous/veterinary ; Struthioniformes/*metabolism

Acne Vulgaris ; chemically induced ; drug therapy ; Administration, Topical ; Adolescent ; Adrenal Cortex Hormones ; administration & dosage ; therapeutic use ; Anti-Bacterial Agents ; administration & dosage ; adverse effects ; therapeutic use ; Doxycycline ; administration & dosage ; adverse effects ; therapeutic use ; Drug Therapy, Combination ; Humans ; Isotretinoin ; administration & dosage ; therapeutic use ; Male ; Thorax

The year 1943 saw the introduction, by Mahoney and his associates, of penicillin treatment for syphilis. That period was an epic turning point in many respects, not least of which was the commencement of the antibiotic era in venereology. Frorn that point on, there were no antibiotics as effective, as cheap,or as low in toxicity as penir.illin, despite the discovery of a number of ather. a.ntibiotics. Also, na signs of resistance by Treponema pallidum t,o the antibiotic have yet been noted, although this possibility ha.a not bcen evaluated adequately. Sirice then Benzathine penicillin G, a long acting l3epo-penicillin, (discovered by Seifter, et al, in 1951), has been uti.lized for treating ayphilis. Aft.er the discovery of penicillin, syphilis began to decline. However, during the r.niddle 1950s the incidence of syphilis began to increa se throughout the world. In the 1960's, this rate of increase became quite pronounced. Thus, the present trend. is to treat most syphi]is with Benzathine penicillin Ci. However, occasional adverse reacf.ions, (e.g. hypersensitivity, anaphyIactic shack, phobia of injections and other untoward effects), sometimes render treatment with Renzathine Fenicillin G irnpossible. In such cases, treatment consists of the oral administration of Vibramycin' (Doxycycline to compensate for the defects of the penicillin. Although the previous alternatives have tra,ditionally been Tetracycline and Erythromyr,in, by utiIizing Vibramycin, we are a.41e to repozt the results comparing the effectiveness of Vibramycin with the effectiveness of Renza.cillin. The results focus on clini.cal irnprcivement and serological tests. Thirty five patients were treateif, with Vibramycin, but despite our requests, only ten patients participated in the foliowup study. among these ten patients, three patients were hypersensitive to penicillin. Forty nine patients were treated with Benzacillin, among which only thirteen patients responded to our follow-up studies. All members of the Benzacillin group were skin tested for penicillin hypersensitivity before treatment was initiated. The Vibramycin treatment regirnen was the oral administration of 200mg twice on the first day, and from the second day to the fourteenth day, 100mg twice daily. Three million units of Benzacillin were given .intra;nuscularly in weekly intervals for three weeks. The therapeutic results obtained were as follows: 1) The Vibramycin group showed remarkable clinical irnprovernent en the third day of treatment, with clinical manifestations completely disappearing en the following days- Lymphangitis dorsalis penis, sixth day of treatment; headache ninth day' maculopapulo-squamous syphilids, eleventh day; condyloma lata, fourteenth day' primary chancre, tenth day after finishing treatrnent. However, regional lymphadenopathies persisted for over four and a half months. 2) In most patients, serological follow-up studies, (VDRL slide test, and Wasserrnann complement fixation test), revealed declining titers one month after concluding treatment. These titers continued to decline in the following months. One case of sero-relapse, howe ver, was shown in both the Vibramycin group and the Benzacillin group. R) No cases of side effects were observed in either treatrnent group. 4) It is concluded from this study that nine of ten patients (90%) in the Uibramycin group, and twelve of thirteen patients (92. 3 %) in the Benzacillin group showed serological improvement. Thus, in those instances where penicillin is contraindicated, (e.g. hypersensitivity, anaphylactic shock, etc.), Vibramycin (Doxycycline) appears to be one of the most valuable treatment alternatives available.
Administration, Oral ; Anaphylaxis ; Anti-Bacterial Agents ; Chancre ; Complement System Proteins ; Doxycycline* ; Follow-Up Studies ; Headache ; Humans ; Hypersensitivity ; Incidence ; Lymphangitis ; Male ; Penicillin G Benzathine ; Penicillins ; Penis ; Phobic Disorders ; Serologic Tests ; Skin Tests ; Syphilis* ; Syphilis, Cutaneous ; Tetracycline ; Treponema pallidum ; Venereology

PURPOSE: The aim was to investigate the effect of low dose doxycycline (20 mg) therapy in patients with chronic meibomian gland dysfunction that were refractory to conventional therapy. METHODS: The randomized prospective study enrolled 150 patients (300 eyes) who have chronic meibomian gland dysfunction and who didn't respond to lid hygiene and topical therapy for more than 2 months. All topical therapy was stopped for at least 2 weeks prior to beginning the study. After conducting the tear break up time test (TBUT) and Schirmer test, the authors randomly divided the patients into three groups a high dose group (doxycycline, 200 mg, twice a day), a low dose group (doxycycline, 20 mg, twice a day) and a control group (placebo). After one month, the author repeated the TBUT and Schirmer tests, and analyzed the degree of symptomatic improvement. RESULTS: Compared to the control group, both the high and low dose group showed statistically significant differences after treatment in TBUT, Schirmer test, the number of symptoms reported and the degree of improvement of subjective symptoms. However, there was no statistically significant difference between the high and low dose group after treatment in TBUT (9.42+/-2.87 sec, 9.54+/-1.58 sec, p=0.726), Schirmer test (19.98+/-4.05 mm, 19.65+/-5.02 mm, p=0.624), the number of symptoms reported (1.45+/-0.62, 1.53+/-0.52, p=0.304), as well as the degree of improvement of subjective symptoms (p=0.288). The high dose group (18 patients, 39.13%) reported side effects more frequently than did the low dose group (8 patients, 17.39%) (P=0.002). CONCLUSIONS: Low dose doxycycline (20 mg twice a day) therapy was effective in patients with chronic meibomian gland dysfunction that were refractory to conventional therapy.
Treatment Outcome ; Tears/drug effects/secretion ; Prospective Studies ; Middle Aged ; Meibomian Glands/*drug effects ; Male ; Humans ; Follow-Up Studies ; Female ; Eyelid Diseases/*drug therapy/metabolism ; Doxycycline/*administration & dosage/therapeutic use ; Dose-Response Relationship, Drug ; Chronic Disease ; Anti-Bacterial Agents/*administration & dosage/therapeutic use ; Administration, Oral

OBJECTIVES: Allergic rhinitis (AR) is a chronic upper respiratory tract disease that inflames the mucous membranes of the nose and occurs when circulating inflammatory cells including eosinophils and basophils migrate to and accumulate in the inflammation area by passing through the interstitium and capillary walls. To pass through these barriers, the inflammatory cells degrade extracellular matrix proteins. Matrix metalloproteinases (MMPs) released by inflammatory cells mediate the degradation of these proteins. MMPs have synthetic inhibitors and doxycycline, a tetracycline antibiotic, inhibits MMPs. This study investigated the efficiency of intranasal doxycycline in decreasing the symptoms and inflammatory cell infiltration in an animal model of AR. METHODS: AR was created in female Wistar rats by repeated intranasal challenge with ovalbumin by intraperitoneal injection. For 15 days, topical intranasal doxycycline was administered one hour before ovalbumin administration. Following intranasal administration, nasal symptoms were scored and the nasal mucosae of all rats were evaluated histopathologically. To investigate tissue changes, hematoxyline-eosin and Alcian blue/periodic acid Schiff stains were used. As well, cilia loss, goblet cell changes, vascular congestion, vascular proliferation, inflammatory cell infiltration, eosinophil infiltration and the degree of hypertrophy in chondrocytes were evaluated with light microscopy. RESULTS: Typical symptoms of AR were decreased by intranasal doxycycline administration. These effects were stable after repeated intranasal ovalbumin administration. Histological evaluation of doxycycline treated rats did not reveal typical inflammatory changes associated with AR. CONCLUSION: MMPs may have crucial functions in AR and topical intranasal doxycycline, which decreases inflammatory cell infiltration, may offer an alternative therapy for AR.
Administration, Intranasal ; Animals ; Basophils ; Capillaries ; Chondrocytes ; Cilia ; Coloring Agents ; Doxycycline* ; Eosinophils ; Estrogens, Conjugated (USP) ; Extracellular Matrix Proteins ; Female ; Goblet Cells ; Humans ; Hypertrophy ; Inflammation ; Injections, Intraperitoneal ; Matrix Metalloproteinase Inhibitors ; Matrix Metalloproteinases ; Microscopy ; Models, Animal ; Mucous Membrane ; Nasal Mucosa ; Nose ; Ovalbumin ; Rats* ; Rats, Wistar ; Respiratory Tract Diseases ; Rhinitis* ; Tetracycline