Demeclocycline
Synonym :
Demethylchlortetracycline
Mechanism :
The tetracyclines are primarily bacteriostatic and are thought to exert their antimicrobial effect by the inhibition of protein synthesis. Tetracyclines are active against a wide range of gram-negative and gram-positive organisms. The drugs in the tetracycline class have closely similar antimicrobial spectra, and cross-resistance among them is common.
Indication :
- Rickettsia: (Rocky Mountain spotted fever, typhus fever and the typhus group, Q fever, rickettsia pox, tick fevers)
- Mycoplasma pneumoniae
- Psittacosis and ornithosis
- Lymphogranuloma venereum and granuloma inguinale
- Relapsing fever (Borrelia recurrentis)
- Haemophilus ducreyi (chancroid)
- Yersinia pestis and Francisella tularensis
- Bacteroides species
- Vibrio comma and Vibrio fetus
- Brucella species
Contraindications :
Hypersensitivity to any of the tetracyclines; severe renal or hepatic disease. Therapy of common infections in children under 12. Any condition in which bactericidal effect is essential (bacterial endocarditis). Avoid prophylactic administration to surgical cases, if possible.
Dosing :
>8 years:
6.6-13.2 mg/kg orally divided into two to four doses.
Adverse Effect :
Anorexia, epigastric distress, nausea, vomiting, diarrhea, bulky loose stools, stomatitis, sore throat, glossitis, black hairy tongue, dysphagia, hoarseness, enterocolitis, pancreatitis, maculopapular, erythematous rashes, nephrogenic diabetes insipidus, hepatic cholestasis, pseudotumor cerebri, hypersensitivity reactions, anemia, hemolytic anemia, thrombocytopenia, thrombocytopenic purpura, neutropenia and eosinophilia.
Interaction :
Anticoagulant therapy: May require downward adjustment of their anticoagulant dosage.
Penicillin: May interfere with the bactericidal action of penicillin.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | 600 mg every 24–48 hours |
| <10 | 600 mg every 24–48 hours |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. 600 mg every 48 hours |
| HD | Dialysed. 600 mg post dialysis |
| HDF/High flux | Dialysed. 600 mg post dialysis |
| CAV/VVHD | Unknown dialysability. Dose as in GFR=10–20 mL/min |
Hepatic Dose :
Use with caution. Start with a lower dose. Adjust dose as per clinical response. Monitor LFT before starting and during treatment. Avoid concomitant hepatotoxic drugs.