eMedExpert Home > Compare Drugs > Doxycycline (Doryx)

• Efficacy:
  • Pneumococcal pulmonary infections. In comparative clinical study, in pneumococcal pulmonary infections, the rates of favorable clinical response to doxycycline and minocycline were 73% and 76% respectively 5.
  • Wound infection. In comparative clinical study, in infections caused by bacteroides sp. (mainly infections of wounds), doxycycline or minocycline resulted in a 75% rate of favorable clinical responses and in a 71% rate of favorable bacteriological responses 5.
  • Respiratory infections. Pharmacokinetic studies showed that the Cmax and 0-11 h AUC values in blood are higher for doxycycline, whereas the sputum Cmax was, on average, higher for minocycline because of the greater penetration of the latter. Problems were experienced with both agents in the eradication of Haemophilus influenzae. The net clinical results with the two drugs were identical 3.
  • Urethritis and mucopurulent cervicitis: Minocycline, 100 mg nightly, is as effective as doxycycline, 100 mg twice daily, each given for 7 days in the treatment of nongonococcal urethritis and mucopurulent cervicitis. Vomiting and gastrointestinal upset appear to occur more frequently with doxycycline 8.
• Side effects and tolerability: Adverse events may be less likely with doxycycline than minocycline 7.

• Lyme disease. The principal advantage of doxycycline over tetracycline for the treatment of Lyme disease associated with erythema migrans is the convenience of less frequent dosing, not enhanced efficacy or safety. There appears to be no advantage in extending treatment with doxycycline from 14 to 20 days 6.
• Scrub typhus: In comparative study the cure rate was 100% in the tetracycline group and 93.9% in the doxycycline group. The two groups did not differ significantly in terms of the interval required for defervescence or for the alleviation of symptoms. There were no relapses in either group. These data suggest that 3-day doxycycline therapy is as effective as conventional 7-day tetracycline therapy for the cure of scrub typhus and the prevention of relapses 9.

• Chlamydia and ureaplasma urethritis and cervicitis: A multiple-dose regimen of ofloxacin appears to be a highly effective and well-tolerated alternative to doxycycline in nongonococcal sexually transmitted disease 16.
• Chlamydia trachomatis cervical infection: Women with culture-proven Chlamydia trachomatis cervical infection were randomized to receive either ofloxacin (300 mg) or doxycycline (100 mg), orally twice daily for 7 days. All 56 had negative cultures 5 to 9 days after treatment. Four weeks after treatment, 26 (93%) of 28 ofloxacin-treated patients and all 22 (100%) doxycycline-treated patients were cured 19.
• Male urethritis: In a prospective randomized trial men with uncomplicated urethritis were randomized to receive 1 week of therapy with either doxycycline (100 mg twice daily) or ofloxacin (300 mg twice daily). 56 men received ofloxacin and 52 (93%) were clinically cured. 44 men (83%) of the 53 treated with doxycycline were cured. All 30 patients with gonorrhea who were treated with ofloxacin became culture-negative, as compared with 32 of 34 patients receiving doxycycline. In contrast, three of 18 patients with Chlamydia trachomatis were microbiologic failures after ofloxacin therapy, while all 10 treated with doxycycline were cured. Adverse effects of both treatment regimens were generally mild 20.
• Lower respiratory tract infections: The efficacy and tolerance of ofloxacin and doxycycline were compared in patients with lower respiratory tract infections. 88 patients were treated for exacerbations of chronic bronchitis and 131 for pneumonia. Clinical cure was achieved in 18 of 52 patients with bronchitis treated with ofloxacin. Improvement occurred in 29 and failure in 5. In the doxycycline-treated bronchitis group 11 of 36 patients were cured, 22 improved and 1 failure occurred. Of 62 patients with pneumonia who were administered ofloxacin, 34 were cured, 26 improved and treatment failed in 2. In the doxycycline-treated group of patients with pneumonia 39 of 69 were cured, 23 improved and 7 failed to respond 18.

• Pelvic inflammatory disease: In comparative study, ciprofloxacin treatment was successful in all nine patients with chlamydial or gonococcal PID and in six of seven with nonchlamydial nongonococcal PID. Doxycycline plus metronidazole regimen was successful in five of seven patients with chlamydial or gonococcal PID and in nine of 13 patients with nonchlamydial nongonococcal PID. Thus, the overall success rate was 94% (15 of 16) with ciprofloxacin and 70% (14 of 20) with doxycycline plus metronidazole 17.

• Acne vulgaris. Azithromycin 500 mg once a day for four days per month appears to be as effective as daily doxycycline 100 mg 1.
• Genital chlamydial infections: Azithromycin and doxycycline appear to be equally efficacious in achieving microbial cure and have similar tolerability 11, 12, 14.
• Mucopurulent endocervicitis: In clinical study, the eradication rate of baseline culture-positive cases at the follow-up visit in the azithromycin group was 71.4%, and 77.3% in the doxycycline group. There was no statistically significant difference in efficacy between the single dose azithromycin and seven-day course of doxycycline in the treatment of culture-positive cases of non-gonococcal mucopurulent endocervicitis 13.
• Erythema migrans: Azithromycin (a total dose of 3 g) is equally effective as standard doxycycline treatment (100 mg bid for 14 days) for erythema migrans in adult patients 15.

• Chlamydia trachomatis cervicitis: In the experimental open study, efficacy in the eradication of Chlamydia trachomatis was 91.7% in the group treated with macrolide, and 92% in the group treated with doxycycline. Roxitromycine shows an in vivo activity similar to doxycycline, and is an alternative to the use of doxycycline, being the first choice in those women in whom tetracycline are contraindicated 10.
• Acute exacerbations of chronic bronchitis: The results of the study suggest that roxithromycin and doxycycline are equivalent in terms of efficacy, but that roxithromycin is better tolerated 21.

• Efficacy:
  • Lyme disease. Cefuroxime axetil appears to be equally as effective as doxycycline in the treating of early Lyme disease and in preventing the subsequent development of late Lyme disease 2.
• Side effects and tolerability: Doxycycline is associated with more photo-sensitivity reactions and cefuroxime axetil with more diarrhea and Jarisch-Herxheimer reactions 2.

• Respiratory tract infections. The findings, based on clinical observations, suggest that both antibiotics are equally effective in providing prompt improvement and complete resolution of the infection 4.

• Doxycycline (Doryx) Medical Facts

• 1. Parsad D, Pandhi R, Nagpal R, Negi KS. Azithromycin monthly pulse vs daily doxycycline in the treatment of acne vulgaris. J Dermatol. 2001 Jan;28(1):1-4. PubMed
• 2. Nadelman RB, Luger SW, Frank E, Wisniewski M, Collins JJ, Wormser GP. Comparison of cefuroxime axetil and doxycycline in the treatment of early Lyme disease. Ann Intern Med. 1992 Aug 15;117(4):273-80. PubMed
• 3. Maesen FP, Davies BI, van den Bergh JJ. Doxycycline and minocycline in the treatment of respiratory infections: a double-blind comparative clinical, microbiological and pharmacokinetic study. J Antimicrob Chemother. 1989 Jan;23(1):123-9. PubMed
• 4. Richards JG. Doxycycline and amoxycillin in respiratory infections: a comparative assessment in general practice. Curr Med Res Opin. 1980;6(6):393-7. PubMed
• 5. Klastersky J, Hensgens C, Daneau D. Comparative clinical study of doxycycline and minocycline. Int J Clin Pharmacol Biopharm. 1975 Jan;11(1):19-26. PubMed
• 6. Nowakowski J, Nadelman RB, Forseter G, McKenna D, Wormser GP. Doxycycline versus tetracycline therapy for Lyme disease associated with erythema migrans. J Am Acad Dermatol. 1995 Feb;32(2 Pt 1):223-7. PubMed
• 7. Smith K, Leyden JJ. Safety of doxycycline and minocycline: a systematic review. Clin Ther. 2005 Sep;27(9):1329-42. PubMed
• 8. Romanowski B, Talbot H, Stadnyk M, Kowalchuk P, Bowie WR. Minocycline compared with doxycycline in the treatment of nongonococcal urethritis and mucopurulent cervicitis. Ann Intern Med. 1993 Jul 1;119(1):16-22. PubMed
• 9. Song JH, Lee C, Chang WH, Choi SW, Choi JE, Kim YS, Cho SR, Ryu J, Pai CH. Short-course doxycycline treatment versus conventional tetracycline therapy for scrub typhus: a multicenter randomized trial. Clin Infect Dis. 1995 Sep;21(3):506-10. PubMed
• 10. Rosales M, Domi'nguez V, Bonacho I, Vidal X. Roxithromycin versus doxycycline in the treatment of Chlamydia trachomatis cervicitis in asymptomatic women. Rev Clin Esp. 1993 Apr;192(6):253-5. PubMed
• 11. Lau CY, Qureshi AK. Azithromycin versus doxycycline for genital chlamydial infections: a meta-analysis of randomized clinical trials. Sex Transm Dis. 2002 Sep;29(9):497-502. PubMed
• 12. Ossewaarde JM, Plantema FH, Rieffe M, Nawrocki RP, de Vries A, van Loon AM. Efficacy of single-dose azithromycin versus doxycycline in the treatment of cervical infections caused by Chlamydia trachomatis. Eur J Clin Microbiol Infect Dis. 1992 Aug;11(8):693-7. PubMed
• 13. Sendag( F, Terek C, Tuncay G, Ozkinay E, Guven M. Single dose oral azithromycin versus seven day doxycycline in the treatment of non-gonococcal mucopurulent endocervicitis. Aust N Z J Obstet Gynaecol. 2000 Feb;40(1):44-7. PubMed
• 14. Lauharanta J, Saarinen K, Mustonen MT, Happonen HP. Single-dose oral azithromycin versus seven-day doxycycline in the treatment of non-gonococcal urethritis in males. J Antimicrob Chemother. 1993 Jun;31 Suppl E:177-83. PubMed
• 15. Barsic B, Maretic T, Majerus L, Strugar J. Comparison of azithromycin and doxycycline in the treatment of erythema migrans. Infection. 2000 May-Jun;28(3):153-6. PubMed
• 16. Mogabgab WJ, Holmes B, Murray M, Beville R, Lutz FB, Tack KJ. Randomized comparison of ofloxacin and doxycycline for chlamydia and ureaplasma urethritis and cervicitis. Chemotherapy. 1990;36(1):70-6. PubMed
• 17. Heinonen PK, Teisala K, Miettinen A, Aine R, Punnonen R, Gronroos P. A comparison of ciprofloxacin with doxycycline plus metronidazole in the treatment of acute pelvic inflammatory disease. Scand J Infect Dis Suppl. 1989;60:66-73. PubMed
• 18. Harazim H, Wimmer J, Mittermayer HP. An open randomised comparison of ofloxacin and doxycycline in lower respiratory tract infections. Drugs. 1987;34 Suppl 1:71-3. PubMed
• 19. Hooton TM, Batteiger BE, Judson FN, Spruance SL, Stamm WE. Ofloxacin versus doxycycline for treatment of cervical infection with Chlamydia trachomatis. Antimicrob Agents Chemother. 1992 May;36(5):1144-6. PubMed
• 20. Harazim H, Wimmer J, Mittermayer HP. An open randomised comparison of ofloxacin and doxycycline in lower respiratory tract infections. Drugs. 1987;34 Suppl 1:71-3. PubMed
• 21. De Vlieger A, Druart M, Puttemans M. Roxithromycin versus doxycycline in the treatment of acute exacerbations of chronic bronchitis. Diagn Microbiol Infect Dis. 1992 May-Jun;15(4 Suppl):123S-127S. PubMed