Doxycycline is an old tetracycline-like antibiotic with a comparatively good side-effect profile, but it doesn’t get much love in the guidelines for community-acquired pneumonia as the evidence level was deemed to be low. A recent issue of Clinical Infectious Diseases contained a systematic review with a meta-analysis.

Dr. Brad Spellberg is the chief medical office at the Los Angeles County-University of Southern California Medical Center. Dr. Spellberg is also a professor of clinical medicine and the associate dean for clinical affairs at the USC’s Keck School of Medicine.

I talk with him about why doxy might be a good CAP drug (and when it is not a good choice), guidelines and the process of creating guidelines, and resistance patterns, MICs, and clinical significance.

References:

-Shorter Is Better: https://www.bradspellberg.com/shorter-is-better

-Oral Is the New IV: https://www.bradspellberg.com/oral-antibiotics

-WikiGuidelines: https://www.wikiguidelines.com/

-SH Choi et al.: Clin Infect Dis. 2022 Jul 29;ciac615. https://pubmed.ncbi.nlm.nih.gov/35903011/

-NICE: Pneumonia (community-acquired): antimicrobial prescribing. Published: 16 September 2019. https://www.nice.org.uk/guidance/ng138

-JP Metlay et al. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67. doi: 10.1164/rccm.201908-1581ST. https://pubmed.ncbi.nlm.nih.gov/31573350/

YouTube channel: https://www.youtube.com/@IMJournalClub

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