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A randomized trial of doxycycline for Mansonella perstans infection. Mansonella perstans infection is common in areas of Africa where Wuchereria bancrofti, a causative agent of lymphatic filariasis, is endemic. M. perstans is refractory to standard antifilarial therapies. The recent discovery of bacterial endosymbionts (e.g., wolbachia) in most filarial species, including M. perstans, provides new therapeutic options for reducing microfilaremia.In an open-label, randomized trial, we recruited (...) subjects with M. perstans microfilaremia, with or without concomitant W. bancrofti infection, from four villages in Mali and randomly assigned them to receive doxycycline, at a dose of 200 mg daily for 6 weeks (106 subjects), or no treatment (110). At 6 months, subjects who were coinfected with W. bancrofti underwent a second random assignment, to treatment with a single dose of albendazole (400 mg) and ivermectin (150 microg per kilogram of body weight) or no treatment. Subjects were monitored daily
Oral doxycycline versus intravenous ceftriaxone for European Lyme neuroborreliosis: a multicentre, non-inferiority, double-blind, randomised trial Use of intravenous penicillin and ceftriaxone to treat Lyme neuroborreliosis is well documented, although oral doxycycline could be a cost-effective alternative. We aimed to compare the efficacy of oral doxycycline with intravenous ceftriaxone for the treatment of Lyme neuroborreliosis.From April, 2004, to October, 2007, we recruited consecutive (...) adult patients from nine hospitals in southern Norway into a non-inferiority trial. Inclusion criteria were neurological symptoms suggestive of Lyme neuroborreliosis without other obvious causes, and presence of any of the following: a CSF white-cell count of more than five per mL; intrathecal production of specific Borrelia burgdorferi antibodies; or acrodermatitis chronicum atrophicans. Patients were randomly allocated to receive 200 mg oral doxycycline or 2 g intravenous ceftriaxone once per day
Postexposure treatment with doxycycline for the prevention of tick-borne relapsing fever. Tick-borne relapsing fever (TBRF) is an acute febrile illness. In Israel, TBRF is caused by Borrelia persica and is transmitted by Ornithodoros tholozani ticks. We examined the safety and efficacy of postexposure treatment to prevent TBRF.In a double-blind, placebo-controlled trial, 93 healthy subjects with suspected tick exposure (52 with signs of tick bites and 41 close contacts--those without signs (...) but with a similar risk of contact with ticks) were randomly assigned to receive either doxycycline (Dexxon, in a dose of 200 mg the first day and then 100 mg per day for four days) or placebo after presumed exposure to TBRF. Cases of TBRF were defined by fever and a positive blood smear. Serologic analysis for cross-reactivity to Borrelia burgdorferi and polymerase chain reaction (PCR) for the borrelia glpQ gene were also performed.After randomization, 47 subjects (26 with signs of tick bites and 21 close
Macrofilaricidal activity after doxycycline treatment of Wuchereria bancrofti: a double-blind, randomised placebo-controlled trial. Wolbachia endosymbionts of filarial nematodes are vital for larval development and adult-worm fertility and viability. This essential dependency on the bacterium for survival of the parasites has provided a new approach to treat filariasis with antibiotics. We used this strategy to investigate the effects of doxycycline treatment on the major cause of lymphatic (...) filariasis, Wuchereria bancrofti.We undertook a double-blind, randomised, placebo-controlled field trial of doxycycline (200 mg per day) for 8 weeks in 72 individuals infected with W bancrofti from Kimang'a village, Pangani, Tanzania. Participants were randomly assigned by block randomisation to receive capsules of doxycycline (n=34) or placebo (n=38). We assessed treatment efficacy by monitoring microfilaraemia, antigenaemia, and ultrasound detection of adult worms. Follow-up assessments were done at 5
2005LancetControlled trial quality: predicted high
Azithromycin versus doxycycline for genital chlamydial infections: a meta-analysis of randomized clinical trials Azithromycin versus doxycycline for genital chlamydial infections: a meta-analysis of randomized clinical trials Azithromycin versus doxycycline for genital chlamydial infections: a meta-analysis of randomized clinical trials Lau C Y, Qureshi A K Authors' objectives To evaluate the efficacy and tolerance of azithromycin versus doxycycline for genital chlamydial infection. Searching (...) Studies published in English were retrieved from the following databases: MEDLINE and Pre-MEDLINE (from 1975 to August 2001), HealthSTAR (from 1975 to August 2001), EBM Reviews: Best Evidence (from September 1991 to January/February 2001), EBM Reviews: Cochrane Database of Systematic Reviews (second quarter of 2001), and EBM Reviews: DARE (second quarter of 2001). The medical subject headings 'CT' and 'doxycycline' or 'CT' and 'azithromycin' were used as search terms. Bibliographies of computer
Prophylaxis with single-dose doxycycline for the prevention of Lyme disease after an Ixodes scapularis tick bite. It is unclear whether antimicrobial treatment after an Ixodes scapularis tick bite will prevent Lyme disease.In an area of New York where Lyme disease is hyperendemic we conducted a randomized, double-blind, placebo-controlled trial of treatment with a single 200-mg dose of doxycycline in 482 subjects who had removed attached I. scapularis ticks from their bodies within the previous (...) 72 hours. At base line, three weeks, and six weeks, subjects were interviewed and examined, and serum antibody tests were performed, along with blood cultures for Borrelia burgdorferi. Entomologists confirmed the species of the ticks and classified them according to sex, stage, and degree of engorgement.Erythema migrans developed at the site of the tick bite in a significantly smaller proportion of the subjects in the doxycycline group than of those in the placebo group (1 of 235 subjects [0.4
Doxycycline and rifampicin for mild scrub-typhus infections in northern Thailand: a randomised trial. Some strains of scrub typhus in northern Thailand are poorly responsive to standard antirickettsial drugs. We therefore did a masked, randomised trial to compare rifampicin with standard doxycycline therapy for patients with scrub typhus.Adult patients with strictly defined, mild scrub typhus were initially randomly assigned 1 week of daily oral treatment with 200 mg doxycycline (n=40), 600 mg (...) rifampicin (n=38), or doxycycline with rifampicin (n=11). During the first year of treatment, the combined regimen was withdrawn because of lack of efficacy and the regimen was replaced with 900 mg rifampicin (n=37). Treatment outcome was assessed by fever clearance time (the time for oral temperature to fall below 37.3 degrees C).About 12,800 fever patients were screened during the 3-year study to recruit 126 patients with confirmed scrub typhus and no other infection, of whom 86 completed therapy
Doxycycline is a cost-effective therapy for hospitalized patients with community-acquired pneumonia Doxycycline is a cost-effective therapy for hospitalized patients with community-acquired pneumonia Doxycycline is a cost-effective therapy for hospitalized patients with community-acquired pneumonia Ailani R K, Agastya G, Ailani R K, Mukunda B N, Shekar R Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains (...) a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Doxycycline for hospitalised patients with community-acquired pneumonia. The dosage was 100mg given intravenously every 12 hours. This was switched to 100mg orally every 12 hours for patients in the intervention group who improved. Type of intervention Treatment. Economic study type Cost-effectiveness analysis. Study
Ceftriaxone compared with doxycycline for the treatment of acute disseminated Lyme disease. Localized Lyme disease, manifested by erythema migrans, is usually treated with oral doxycycline or amoxicillin. Whether acute disseminated Borrelia burgdorferi infection should be treated differently from localized infection is unknown.We conducted a prospective, open-label, randomized, multicenter study comparing parenteral ceftriaxone (2 g once daily for 14 days) with oral doxycycline (100 mg twice (...) with ceftriaxone (85 percent) and those treated with doxycycline (88 percent); treatment was considered to have failed in only one patient in each group. Among patients whose infections were cured, 18 of 67 patients in the ceftriaxone group (27 percent) reported one or more residual symptoms at the last follow-up visit, as did 10 of 71 patients in the doxycycline group (14 percent, P > or = 0.05). Mild arthralgia was the most common persistent symptom. Both regimens were well tolerated; only four patients (6
Doxycycline compared with azithromycin for treating women with genital Chlamydia trachomatis infections: an incremental cost-effectiveness analysis Doxycycline compared with azithromycin for treating women with genital Chlamydia trachomatis infections: an incremental cost-effectiveness analysis Doxycycline compared with azithromycin for treating women with genital Chlamydia trachomatis infections: an incremental cost-effectiveness analysis Magid D, Douglas J, Schwartz S Record Status (...) . Doxycycline compared with azithromycin for treating women with genital Chlamydia trachomatis infections: an incremental cost-effectiveness analysis. Annals of Internal Medicine 1996; 124(4): 389-399 PubMedID Indexing Status Subject indexing assigned by NLM MeSH Analysis of Variance; Azithromycin /administration & Chlamydia Infections /drug therapy /economics; Chlamydia trachomatis; Cost-Benefit Analysis; Decision Trees; Doxycycline /administration & Drug Administration Schedule; Female; Genital Diseases
Randomised controlled comparison of single-dose ciprofloxacin and doxycycline for cholera caused by Vibrio cholerae 01 or 0139. Effective antimicrobial therapy can reduce the duration and volume of cholera diarrhoea by half. However, such treatment is currently limited by Vibrio cholerae resistance to the drugs commonly prescribed for cholera, and by the difficulties involved in the administration of multi-drug doses under field conditions. Because of its favourable pharmacokinetics we thought (...) it likely that single-dose ciprofloxacin would be effective in the treatment of cholera.In this double-blind study treatment was either a single 1 g oral dose of ciprofloxacin plus doxycycline placebo, or a single 300 mg oral dose of doxycycline plus ciprofloxacine placebo. 130 moderately or severely dehydrated men infected with V cholerae 01 and 130 infected with V cholerae 0139 were randomly assigned treatment. Patients stayed in hospital for 5 days. We measured fluid intake and stool volume every 6 h
1996LancetControlled trial quality: predicted high
Ciprofloxacin compared with doxycycline for nongonococcal urethritis. Ineffectiveness against Chlamydia trachomatis due to relapsing infection. We compared 7-day regimens of ciprofloxacin in dosages of 750 and 1000 mg twice daily with doxycycline 100 mg twice daily for the treatment of nongonococcal urethritis in 178 men enrolled in a prospective, randomized, double-blind trial. The overall clinical response was comparable in the three treatment groups at both 2 and 4 weeks after therapy (...) . However, among patients who initially had cultures positive for chlamydia, Chlamydia trachomatis was reisolated within 4 weeks after treatment in none of 10 doxycycline-treated patients, in 11 (52%) of 21 patients treated with 750 mg of ciprofloxacin twice daily, and in six (38%) of 16 patients treated with 1000 mg of ciprofloxacin twice daily. Each of the recurrent strains was identical in serotype to the original infecting strain. We conclude that ciprofloxacin in dosages as high as 2 g daily
Amoxycillin plus probenecid versus doxycycline for treatment of erythema migrans borreliosis. 72 adults with erythema migrans (early Lyme borreliosis) were enrolled in a randomised prospective trial comparing amoxycillin 500 mg plus probenecid 500 mg three times a day with doxycycline 100 mg twice a day for 21 days. These antibiotic regimens were chosen because of the known in-vitro sensitivity of Borrelia burgdorferi, the antibiotic tissue penetration, the pharmacokinetics of the drugs (...) , and because the organism can disseminate early in the course of infection. 72 patients were evaluable (35 in the doxycycline group and 37 in the amoxycillin/probenecid group). The two regimens were equally effective for treatment of erythema migrans. Mild fatigue or arthralgia were the only post-treatment complaints, which resolved within 6 months. None of the patients needed further antibiotic treatment for Lyme borreliosis.
Randomised double blind trial of single dose doxycycline for treating cholera in adults. To compare the efficacy of a single dose of doxycycline (200 or 300 mg) with the standard multiple doses of tetracycline in patients with cholera.Randomised double blind controlled trial. Patients were given a single 200 mg dose of doxycycline, a single 300 mg dose of doxycycline, or multiple doses of tetracycline (500 mg, six hourly intervals).Hospital in Bangladesh treating diarrhoea.261 Patients aged (...) weight) and till diarrhoea stopped (296 ml/kg body weight) were significantly higher in patients receiving 200 mg doxycycline as a single dose than in patients receiving either standard tetracycline (242 ml/kg body weight and 254 ml/kg body weight) or 300 mg doxycycline (226 ml/kg body weight and 255 ml/kg body weight). Similarly, median consumption of oral rehydration solution (18.45 l) was significantly higher in patients receiving 200 mg doxycycline than in patients receiving either 300 mg
Doxycycline prophylaxis for falciparum malaria. 188 schoolchildren aged 10-15 living in a malaria endemic area along the Thai-Burmese border were matched for age, splenomegaly, and weight and were then randomly assigned to receive either doxycycline (adult equivalent of 100 mg daily) or chloroquine (adult equivalent of 300 mg base weekly). All drugs were administered by the investigators and blood smears were done weekly. In 95 subjects taking doxycycline for 597 man-weeks there were 5 cases (...) of falciparum malaria and in the 93 controls taking chloroquine for 488 man-weeks there were 31. Doxycycline was more effective than chloroquine in the prevention of falciparum malaria infections (p less than 0.0001). The doxycycline group did not have significantly more side-effects than the chloroquine group.
An efficacy trial of doxycycline chemoprophylaxis against leptospirosis. Because leptospirosis has been an important cause of morbidity in U.S. soldiers training in the Republic of Panama, we conducted a randomized, double-blind, placebo-controlled field trial during the fall of 1982 to determine whether doxycycline was an effective chemoprophylactic agent against this infection. Doxycycline (200 mg) or placebo was administered orally on a weekly basis and at the completion of training to 940 (...) volunteers from two U.S. Army units deployed in Panama for approximately three weeks of jungle training. Twenty cases of leptospirosis occurred in the placebo group (an attack rate of 4.2 per cent), as compared with only one case in the doxycycline group (attack rate, 0.2 per cent, P less than 0.001), yielding an efficacy of 95.0 per cent. This study demonstrated the value of doxycycline as a prophylactic drug against leptospirosis.
Prophylactic doxycycline for travelers' diarrhea. Results of a prospective double-blind study of Peace Corps volunteers in Kenya. We performed a randomized double-blind study to determine the efficacy of doxycycline (100 mg daily) in preventing travelers' diarrhea among 39 Peace Corps volunteers during their first five weeks in Kenya. The volunteers took either doxycycline or placebo for three weeks and were observed for an additional two weeks. Nine of 21 taking placebo and one of 18 taking (...) doxycycline had travelers' diarrhea during the treatment period (P = 0.012). The protection seemed to persist for at least one week after the drug was stopped. Enterotoxigenic Escherichia coli was the only pathogen isolated from the placebo group, but was not detected in persons taking doxycycline. None of these organisms were resistant to doxycycline or tetracycline, whereas resistance to tetracyclines and other antibiotics was common among the nonenterotoxigenic Esch. coli. We conclude that doxycycline
Doxycycline treatment and human infertility. The role of mycoplasmas in infertility was studied in 120 couples. During the twelve months of the study 27 couples (22-5%) conceived. T mycoplasmas were isolated from 63% of these couples, and Mycoplasma hominis from 18%, compared with 56% and 13%, respectively, in those who did not conceive. 88, with primary infertility of unascertained cause, took part in a controlled trial with doxycycline. The couples in the trial were allocated randomly (...) to three groups: 30 received doxycycline, 28 received a placebo, and 30 couples were untreated. Although a twenty-eight-day course of doxycycline eradicated M. hominis and T-strain mycoplasmas from 27 (96%) of the 28 couples harbouring them, the rate of conception was no higher in those treated with the drug than in control groups. It is concluded that mycoplasmas are not associated with primary infertility and that, although doxycycline eradicates them, this drug is of no benefit in the treatment
Doxycycline treatment of chronic trachoma. 4570291 1973 05 02 2016 10 17 0098-7484 224 2 1973 Apr 09 JAMA JAMA Doxycycline treatment of chronic trachoma. 220-3 Hoshiwara I I Ostler H B HB Hanna L L Cignetti F F Coleman V R VR Jawetz E E eng Clinical Trial Journal Article Randomized Controlled Trial United States JAMA 7501160 0098-7484 0 Placebos N12000U13O Doxycycline AIM IM Adolescent Age Factors Child Chronic Disease Clinical Trials as Topic Doxycycline administration & dosage analysis blood