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Doxycycline versus ...

Doxycycline vs Doryx

Regular doxycycline is dissolved and absorbed in the stomach. Doryx contains specially enteric-coated pellets of doxycycline that pass through the stomach and dissolve only after reaching the small intestine. This helps to reduce gastrointestinal irritation.

Doxycycline vs Tetracycline

The principal differences of doxycycline from tetracycline are the convenience of less frequent administration, high bioavailability, and better tolerance.

Lyme disease

Tetracycline and doxycycline have excellent activity against spirochete Borrelia burgdorferi2.

Both doxycycline and tetracycline are effective for Lyme disease (LD) associated with erythema migrans1. However, doxycycline is preferred to tetracycline, particularly in patients with early disseminated disease, because of improved microbiologic activity and higher cerebrospinal fluid concentrations. Additionally, doxycycline is effective for human granulocytic ehrlichiosis, which may occur simultaneously with early LD.

Rosacea

Both tetracycline and doxycycline can control the symptoms of ocular rosacea 3.

Results of comparison of doxycycline and tetracycline in ocular rosacea 3
Doxycycline
Tetracycline
Regimen 100 mg/day 1000 mg /day
Symptomatic relief after 6 weeks   greater with tetracycline
Symptomatic relief after 3 months
no significant difference
Gastrointestinal tract side effects 12.5%
(2 of 16 patients)
37.5%
(3 of 8 patients)

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 is as effective as conventional 7-day tetracycline therapy for the cure of scrub typhus and the prevention of relapses 9.

Doxycycline vs Ofloxacin

Urethritis and cervicitis

Ofloxacin appears to be effective and well-tolerated alternative to doxycycline in nongonococcal sexually transmitted disease 5, 6.

Results of randomized comparison of ofloxacin and doxycycline for chlamydia and ureaplasma urethritis and cervicitis 5.
Doxycycline
Ofloxacin
Regimen
100 mg twice daily for 7 days
300 mg twice daily for 7 days
Microbiologic response
97%
97%
Combined microbiologic and clinical cure rates
98% (44 of 45 patients)
98% (46 of 47 patients)
Success rate in chlamydial infections
100%
96%
Recurrence of Ureaplasma urealyticum infections
2 of 11 patients
1 of 4 patients
Mixed Chlamydia trachomatis and Ureaplasma urealyticum infections, number of cured patients
3 of 4 patients
5 of 5 patients


Results of comparison of ofloxacin versus doxycycline for of cervical Chlamydia trachomatis 6.
Doxycycline
Ofloxacin
Regimen 100 mg twice daily for 7 days 300 mg twice daily for 7 days
Negative cultures 5 to 9 days after treatment
All patients
Cure rate after 4 week of treatment 100% (22 of 22 patients) 93% (26 of 28 patients)


Male urethritis

Ofloxacin is less effective than doxycycline in chlamydial infections7.

Results of randomized trial of ofloxacin vs. doxycycline in uncomplicated male urethritis7.
Doxycycline
Ofloxacin
Regimen 100 mg twice daily for 7 days 300 mg twice daily for 7 days
Clinical cure rate 83% (44 of 53 patients) 93% (52 of 56 patients)
Culture-negative patients with gonorrhea 32 of 34 patients 30 of 30 patients
Microbiologic failures in patients with Chlamydia trachomatis No microbiologic failures (0 of 10 patoents) 3 of 18 patients

 

Lower respiratory tract infections

Results of randomised comparison of ofloxacin and doxycycline in lower respiratory tract infections11.
Doxycycline
Ofloxacin
Regimen 100 mg twice daily 200 or 400 mg twice daily
Bronchitis, clinical cure rate 11 of 36 patients 18 of 52 patients
Bronchitis, improvement rate 22 of 36 patients 29 of 52 patients
Bronchitis, failure rate 1 of 36 patients 5 of 52 patients
Pneumonia, clinical cure rate 39 of 69 patients 34 of 62 patients
Pneumonia, improvement rate 23 of 69 patients 26 of 62 patients
Pneumonia, failure rate 7 of 69 patients 2 of 62 patients

Doxycycline vs Roxithromycin

Chlamydia

In the experimental open study, efficacy in the eradication of Chlamydia trachomatis was 91.7% in the roxitromycine group, and 92% in the doxycycline group. Roxitromycine shows an in vivo activity similar to doxycycline, and it is an alternative in those women in whom tetracyclines are contraindicated 10.

Bronchitis

The results of the study suggest that roxithromycin and doxycycline have equivalent efficacy for acute exacerbations of chronic bronchitis, but that roxithromycin is better tolerated 12.

Further reading

References
  • 1. 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
  • 2. Ates L, Hanssen-Hübner C, Norris DE, Richter D, Kraiczy P, Hunfeld KP. Comparison of in vitro activities of tigecycline, doxycycline, and tetracycline against the spirochete Borrelia burgdorferi. Ticks Tick Borne Dis. 2010 Mar;1(1):30-4. PubMed
  • 3. Frucht-Pery J1, Sagi E, Hemo I, Ever-Hadani P. Efficacy of doxycycline and tetracycline in ocular rosacea. Am J Ophthalmol. 1993 Jul 15;116(1):88-92. PubMed
  • 4. van der Willigen AH, Polak-Vogelzang AA, Habbema L, Wagenvoort JH. Clinical efficacy of ciprofloxacin versus doxycycline in the treatment of non-gonococcal urethritis in males. Eur J Clin Microbiol Infect Dis. 1988 Oct;7(5):658-61. PubMed
  • 5. 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
  • 6. 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
  • 7. Boslego JW, Hicks CB, Greenup R, Thomas RJ, Wiener HA, Ciak J, Tramont EC. A prospective randomized trial of ofloxacin vs. doxycycline in uncomplicated male urethritis. Sex Transm Dis. 1988 Oct-Dec;15(4):186-91. PubMed
  • 8.
  • 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. 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. 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
  • 12. 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

Published: March 31, 2008
Last updated: June 10, 2014

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