[Doxycycline-induced esophageal ulcers]

Tetracycline is known as one of the antibiotics that induce esophageal ulcers.

Understand how these ulcers may behave and respond to treatment with sucralfate.

During the last two years we studied all patients complaining of dysphagia and odinophagia with an upper GI endoscopy, who were taking doxycycline in the last few days. All of them discontinued the drug once the diagnosis was done and most of them were treated also with sucralfate, 1 g tid.

Eleven patients took doxycycline prescribed for: pelvic inflammatory disease, acne, urinary tract and pulmonary infections. Odinophagia was the most common symptom over the next few days of treatment with some risk factors previously documented, such as taking pills just before bedtime and with a small amount of water. The esophageal ulcers were multiple and located mainly in the middle esophageal third. Symptoms disappeared 3.7 days after the medication was stopped, while those taking sucralfate did not change the period of symptoms.

Physicians must be aware of the doxycycline induced esophageal ulcers and discontinuation of the antibiotic as the main treatment, while sucralfate even though has shown to cover these ulcers, does not change the outcome. Therefore, they must encourage then patients to take the pills with enough liquid, in supine position and have special attention to the elderly and those with any kind of esophageal disease.