Doxycycline for Blepharokeratoconjunctivitis in Children

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

Dosing

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.