Tetracyclines

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 21.12.2021

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Definition
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Broad-spectrum antibiotics. A distinction is made between short-term tetracyclines and long-term tetracyclines.

Half-life
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  • 10 h: tetracycline-HCl, oxytetracycline
  • Long term tetracyclines (15-18 h): Doxycycline, Minocycline

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Pharmacodynamics (Effect)
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Inhibition of the protein biosynthesis of bacteria by disturbing the translation in the ribosomes (30S subunit), bacteriostatic

Spectrum of action
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Acinetobacter spp., Actinomyces spp., Bacillus anthracis, Bordetella pertussis, Borrelia burgdorferi, Brucella spp., Campylobacter spp., Chlamydia spp., Corynebacterium spp., Coxiella burneti, Enterococcus spp., E. coli, Francisella tularensis, Haemophilus spp., Klebsiella spp, Leptospira spp., Listeria monocytogenes, Mycoplasma spp., Nocardia spp., Pasteurella multocida, Pseudomonas mallei, Pseudomonas pseudomallei, Rickettsia, Salmonella spp., Shigella spp., Staphylococcus spp., Streptococcus spp., Treponema pallidum, Vibrio cholerae, Yersinia spp.

Indication
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Among other things in chlamydia and mycoplasma infections, rickettsialpox, brucellosis, tularaemia. Acne vulgaris, actinomycosis, borreliosis, chron. bronchitis, typhus, gonorrhoea and syphilis in penicillin allergy, mixed ENT infections, interstitial peumonia, leptospirosis, melioidosis, plague, prostatitis, Q-fever, rosacea, dysentery.

Undesirable effects
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Bronchospasm, pulmonary infiltrates, tooth discoloration, gastrointestinal disorders, cholestasis, hepatitis, pancreatitis, allergic reactions, purpura, nail discoloration, photosensitization, pericarditis, depression, headaches, intracranial hypertension, visual disorders, arthralgias, myopathies, vulvovaginitis, drug-induced lupus erythematosus.

Interactions
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See Table 1.

Contraindication
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Pregnancy, lactation, children < 8 years, severe liver dysfunction, renal insufficiency, tetracycline intolerance, myasthenia gravis.

Tables
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Major interactions of tetracyclines.

Alcohol abuse, chronic.

Tetracycline degradation↑

Methoxsalen

Photosensitization ↑

Antacids

Tetracycline levels↓

Antidiabetics, oral

Blood sugar lowering ↑

Anticoagulants, oral

Bleeding tendency ↑

Cephalosporins

Cephalosporin action ↓

Ciclosporin A

Toxicity of ciclosporin ↑

Didanosine

Tetracycline effect↓

Digoxin

Digoxin plasma levels ↑

Enzyme inducers

Tetracycline degradation↑

Ergotamine

Vasospasm ↑

Insulin

Insulin action ↑

Contraceptives, oral

contraceptive effect ↓

Lithium salt

Lithium levels ↑

Methotrexate

Methotrexate toxicity ↑

Methoxyflurane

Renal failure

Milk and dairy products

Tetracycline absorption↓

Retinoids

intracranial pressure increase, combination contraindicated

Theophylline

Theophylline plasma levels ↑

Thiomersal

Conjunctivitis with use of thiomersal-containing contact lens cleaners.

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Incoming links (42)

Acitretin; Acne keloidalis nuchae; Actinic reticuloid; Antibiotic allergy; Antibiotics; Antibiotics and abnormal weight gain ; Antiseborrhoics; Botulinum toxin a; Bowel-associated dermatosis-arthritis syndrome; Chlamydiaceae; ... Show all

Outgoing links (17)

Acne (overview); Actinomycosis; Antibiotics; Borreliosis; Brucellosis (overview); Chlamydiaceae; Gonorrhoea (overview); Melioidosis; Penicillin allergy; Photosensitizers; ... Show all

Authors

Last updated on: 21.12.2021

Author: Prof. Dr. med. Peter Altmeyer Prof. Dr. med. Peter Altmeyer

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Structural formula of some important tettracyclines
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