Doxycycline for Blepharokeratoconjunctivitis in Children

• Avoid in younger than age 8 due to concern about teeth yellowing and enamel hypoplasia

• 40-200 mg/day have been used
  • most evidence for 100 mg QD x 3 months or 50 mg QD x 8 months
  • 20 mg tabs BID x 8 weeks may have less side effects
• Duration: 4 weeks to 8 months

• Skin: maculopapular and erythematous rash, photosensitivity and lesions
  • Stevens-Johnsons syndrome rare
• GI: (most common) nausea, emesis, diarrhea, glossitis, esophagitis dysphagia, dyspepsia enterocolitis, rarely pancreatitis
• Hepatotoxicity, dose related rise in BUN
• Renal toxicity
• Blood: hemolytic anemia, thrombocytopenia, neutropenia, eosinophilia
• CNS: Intracranial hypertension
• Discolorations: tooth enamel- maybe permanent in primary teeth, reversable in adult teeth. Browning of the thyroid gland (microscopic) without functional problems.
• Psychiatric: depression, anxiety, suicidal ideation, insomina, hallucinations, abnormal dreams.

• Supratheraputic INR in those taking coumadin

• pregnancy
• nursing mothers
• <8 years old

Oral Antibiotics for Meibomian Gland-Related Ocular Surface Disease
The end of a dogma: the safety of doxycycline use in young children for malaria treatment