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Minimal Erythema Dose MED Testing
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Is Doxycycline Appropriate for Routine Treatment of Young Children With Erythema Migrans?

Gary P Wormser1, Franc Strle2, Eugene D Shapiro3

  • 1From the Division of Infectious Diseases, New York Medical College, Valhalla, New York.

The Pediatric Infectious Disease Journal
|October 19, 2019
PubMed

Insights

Doxycycline may cause fewer permanent teeth stains in children than older tetracyclines, but the risk remains uncertain. Therefore, it should not be routinely used for pediatric Lyme disease treatment when other effective options exist.

Area of Science:

  • Pediatric infectious diseases
  • Pharmacology and toxicology

Background:

  • Tetracyclines, including doxycycline, are used to treat Lyme disease.
  • Concerns exist regarding permanent teeth staining in young children with tetracycline use.
  • Doxycycline is presumed to have a lower risk of teeth staining compared to older tetracyclines.

Purpose of the Study:

  • To evaluate the risk of permanent teeth staining in young children treated with doxycycline.
  • To inform clinical guidelines on the use of doxycycline for pediatric Lyme disease.

Main Methods:

  • This study is a review of existing literature and data.
  • Analysis of reported cases of teeth staining associated with doxycycline in pediatric populations.

Main Results:

  • The precise risk of permanent teeth staining from doxycycline in young children is not definitively established.
  • Available data suggest a potentially lower frequency compared to older tetracyclines, but uncertainty persists.

Conclusions:

  • Doxycycline should not be routinely prescribed for young children with erythema migrans (Lyme disease).
  • Alternative antimicrobials are available and highly effective for treating pediatric Lyme disease.
  • Further research is needed to precisely quantify the risk of doxycycline-induced teeth staining.

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