Association Between Doxycycline Chemoprophylaxis and the Development of Gastrointestinal Conditions in Military
Matthew Olsen1, Kwame Peprah Boaitey2, Robin Orr1,3
1Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia.
Introduction:
Military and other specialist personnel may be exposed to malaria during deployment. Doxycycline is a frequently prescribed malarial chemoprophylaxis, but its use is associated with gastrointestinal adverse effects. The aim was to investigate the association between extended use of doxycycline malarial chemoprophylaxis within a military population and the development of GI conditions.
Methods:
Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, a systematic search of academic databases was undertaken. Dedicated inclusion and exclusion eligibility criteria were applied to ensure only studies meeting the research intent were retained. Remaining studies were assessed for study quality using Critical Appraisal Skills Programme (CASP) appraisal tools. The study protocol was registered with the Open Science Framework.
Results:
Eleven studies randomized control field trials (RCTs), n = 3: retrospective quantitative (mainly) survey-based studies n = 8) from seven different countries, meet the eligibility criteria. Reports of adverse GI effects (n = 2322) were recorded representing between 3% and 79% (median 39%) of participants across the studies. RCTs CASP appraisal results were generally higher (high quality) as compared to the survey-based studies (moderate quality). The unique focus of this systematic review enabled scrutinization of the frequency, severity and potential risk to long term health of extended doxycycline use for currently serving and veteran population.
Conclusions:
Within the population studied, doxycycline chemoprophylaxis is frequently associated with a range of GI-related adverse effects from mild to severe and chronic conditions which, with extended use, have the potential to impact long-term health and quality of life. Pragmatic recommendations targeted to military and veteran organizations aim to minimize some adverse outcomes. Large-scale, longitudinal studies are needed to more accurately establish the risk profile of extended doxycycline use for malarial prophylaxis.
More Related Videos
06:55Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020
08:33Quantitative Polymerase Chain Reaction-based Analyses of Murine Intestinal Microbiota After Oral Antibiotic Treatment
Published on: November 17, 2018
Related Concept Videos
01:18Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents
01:17Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
01:25Factors Influencing Drug Absorption: Disease States and Pharmacology
Substances such as alcohol and specific drugs, including antineoplastics, can also negatively impact drug absorption. For instance,...
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...