Doxycycline

Doxycycline is an antibiotic. It is clinically effective in the treatment of a variety of infections caused by susceptible strains of Gram-positive and Gram-negative bacteria and certain other micro- organisms.

These bacteria are responsible for infections such as chest infections, skin infections, rosacea, dental infections and sexually transmitted infections (STIs),

Doxycycline can also be used to prevent malaria if you’re travelling abroad.

Doxycycline is available on prescription. It comes as capsules.

Doxycycline belongs to a class of drugs called tetracyclines. Doxycycline works by blocking a bacterial protein from being made. It does this by binding to certain units of the protein. This stops the protein from growing and treats your infection.

The capsules should be swallowed with plenty of fluid in an upright position and well before going to bed. This is to reduce the likelihood of oesophageal irritation and ulceration.

If gastric irritation occurs, it is recommended that Doxycycline Capsules be given with food or milk.

Dosage

100mg twice daily for 7 days is recommended

Permanent change of tooth colour warning: This drug may cause permanent changes in tooth colour in children if it’s used during tooth development. This time includes the last half of pregnancy through 8 years of age. Children’s teeth may change to yellow, grey, or brown.

Antibiotic-associated diarrhoea warning: This drug may cause antibiotic-associated diarrhoea. This can range from mild diarrhoea to severe infection of the colon. In rare cases, this effect can be fatal (cause death). If you have severe or persistent diarrhoea, tell your doctor. They may stop your treatment with this drug.

Intracranial hypertension warning: This drug may cause intracranial hypertension, or high blood pressure inside your skull. Symptoms may include headache, blurry vision, double vision, and vision loss. Tell your doctor right away if you have these symptoms. You may also have swelling inside of your eyes. Women of childbearing age who are overweight have a higher risk of this condition. If you’ve had intracranial hypertension before, your risk is also higher.

Severe skin reaction warning: This drug can cause serious skin reactions. These include conditions called Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms (DRESS). Symptoms can include blisters, peeling skin, and a rash of small purple spots. If you have any of these symptoms, stop taking this drug and call your doctor right away.

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Common side effects

• loss of appetite
• nausea and vomiting
• diarrhoea
• rash
• sensitivity to the sun
• hives
• temporary discolouring of adult teeth (goes away with dentist cleaning after the drug is stopped)

Serious side effects

• severe diarrhoea
• bloody diarrhoea
• stomach cramping and pain
• fever
• dehydration
• loss of appetite
• weight loss
• High blood pressure inside your skull. Symptoms can include:
• headache
• blurry vision
• double vision
• vision loss
• irritation of your oesophagus or ulcers in your oesophagus (may be more likely if you take your dose at bedtime). Symptoms can include:
• burning or pain in your chest
• anaemia
• Pancreatitis. Symptoms can include:
• pain in your upper abdomen, or pain in your abdomen that moves to your back or gets worse after you eat
• fever
• Serious skin reactions. Symptoms can include:
• blisters
• peeling skin
• a rash of small purple spots

Reporting of side effects

If you get any side effects, talk to your doctor. This includes any possible side effects not listed in this leaflet. You can also report side effects directly (see details below). By reporting side-effects you can help provide more information on the safety of this medicine.

United Kingdom

Yellow Card Scheme

Website: www.mhra.gov.uk/yellowcard

or search for MHRA Yellow Card in the Google Play or Apple App Store.

You can test for chlamydia at home or in a clinic. A swab or urine sample can be used.

Females: Usually take a swab, place it in a urine (universal container) and send it to a laboratory.

Males:  Usually require a urine test.

Your doctor or GUM specialist will advise you which is best. They could also recommend you have rectal and throat testing, especially for those known to be HIV positive.

Home screening tests are available, but it is not always easy to do them correctly at home, for this reason it is advised that if such tests are performed you have follow-up appointments with a doctor.

It is recommended to perform tests before and after treatment to ensure resolution.

Chlamydia testing kits are available online.

Chlamydia is referred to as the ‘silent’ infection, most infected individuals do not display any symptoms or elicit signs in a medical examination.

It is unclear exactly what percentage of infected individuals display symptoms, some surveys have suggested that only about 10% of men and 5-30% of women with confirmed infection develop symptoms.

Chlamydia has a slow replication cycle once inside the body, symptoms (for those who show symptoms) may not appear until several weeks after exposure.

Infection in women

the bacteria initially infect the cervix, upper reproductive tracts, urethra.

Infection of the cervix:

This causes signs and symptoms of cervicitis; purulent discharge, bleeding.

Infection to the upper reproductive tract (i.e., uterus, fallopian tubes),

Signs and symptoms of pelvic inflammatory disease (PID). PID can be subclinical, ie produce no symptoms). If symptomatic it causes, abdominal and/or pelvic pain along with uterine or adnexal tenderness.

Infection of the urethra:

Results in signs and symptoms of urethritis (e.g., pyuria, dysuria, urinary frequency).

Infection in men:

Symptomatic men typically have urethritis, this produces a purulent, mucoid or water discharge from the penis. There is also pain when passing urine (dysuria).

A small number of infected men develop epididymitis, the symptoms of which are testicular pain (one side), tenderness, and swelling.

Chlamydia can infect the rectum in both men and women.

If this is symptomatic it causes proctitis (e.g., rectal pain, discharge, and/or bleeding).

Sexually acquired chlamydial conjunctivitis can occurs when eyes come in contact with infected genital secretions.

Chlamydial infections in the throats are typically symptomless

Any sexually active person can be infected with chlamydia. It is a very common STI.

It is estimated that 1 in 20 young women (sexually active) between the ages of 14-24 years has chlamydia.

The reasons behind this high incidence is a combination of behavioural, biological, and cultural reasons. Some young people don’t use condoms regularly.

Teenage girls and young women may have cervical ectopy (where cells from the endocervix are present on the ectocervix).

Cervical ectopy may increase susceptibility to chlamydial infection.

The higher prevalence of chlamydia among young people also may also be attributed accessing STI prevention services, lack of transportation, cost, and stigma.

If you have any symptoms of chlamydia you should visit your GP, local genitourinary medicine (GUM) clinic or local contraceptive service as soon as possible.

If you are concerned you may have a an STI (from a sexual contact) but are asymptomatic, you need to get tested. You can get tested community pharmacies, colleges and youth centres.

Where possible sexual partners should be notified that you require Chlamydia treatment

This can be dealt with confidentially and sensitively,

Sexual health clinics (GUM clinics) can help with confidential partner notification. They also advise on treatment and help with any other concerns regarding your STI.

What complications can result from chlamydial infection?

The initial damage may go unnoticed, but Chlamydia can cause serious long-term problems.

Women:

Untreated chlamydia can spread into the reproductive organs and cause chronic infections (Pelvic Inflammatory Disease)

Chlamydia can cause permanent damage to the fallopian tubes, uterus, and surrounding tissues. The damage can lead to chronic pain, infertility and potentially fatal ectopic pregnancy.

Chlamydial PID in some patients develops into a liver inflammation peri hepatitis, or “Fitz-Hugh-Curtis Syndrome” causing right upper quadrant pain.

Untreated chlamydia in pregnant woman has been associated with pre-term babies, pneumonia and conjunctivitis of the newborn.

Reactive arthritis can occur in men and women following chlamydial infection.

It is important you refrain from sexual contact/activity for 7-day duration of the treatment course until you are no longer infectious.

Most people may not have any symptoms and even if you do, you may not notice them for several weeks or months.

Chlamydia Symptoms in women:

Increase in vaginal discharge

Pain or burning when urinating

Pain during sex and or bleeding

Pain in the lower stomach

Bleeding in between periods/heavier bleeding

Chlamydia Symptoms in men:

White, cloudy or watery discharge from the penis

Pain when urinating

Pain and swelling of testicles

Chlamydia infection can also be in the anus, eyes and throat.

This causes pain, discharge or bleeding in the anus, or inflammation of the eye (conjunctivitis).