Tetracycline and doxycycline frequently are prescribed to wanton for a number of different infectious diseases. Although both are considered to be broad spectrum, runny common pathogens have acquired resistance to them, leaving a fairly finite list of indicated uses. This list includes the treatment of several sexually transmitted diseases, pelvic inflammatory disease and endometritis, and acne. The principal contraindications to their use are breast feeding, pregnancy, age less than 8 years, and impaired renal or hepatic function. The main toxicities are staining of teeth, stippling of bones, and photosensitivity. Renal, central nervous system, hepatic, and gastrointestinal disturbances also have been documented. When taken with food or certain medications, tetracycline is poorly absorbed, making adequate serum concentrations difficult to attain. Doxycycline is better absorbed. The volume of distribution for both drugs is essentially that of the body's serum, including small amounts in breast milk, secretions, cerebrospinnl fluid, and amniotic fluid. The drugs are metabolized in the liver and then eliminated in the urine (tetracycline) or feces (doxycycline). Subtle differences in the metabolism and side effects of the two medications favor the use of doxycycline over tetracycline in most instances. In spite of their limitations, when used properly, tetracycline and doxycycline are safe, effective, and inexpensive antimicrobials.
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