Tetracyclines

Author: Prof. Dr. med. Peter Altmeyer

All authors of this article

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.