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Malar J. 2017 Apr 13;16(1):148. doi: 10.1186/s12936-017-1797-9.

The end of a dogma: the safety of doxycycline use in young children for malaria treatment.

Author information

1
Fédération des Laboratoires, Hôpital d'Instruction des Armées Desgenettes, Lyon, France.
2
Unité de Parasitologie et d'Entomologie, Département des Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, HIA Laveran, Boulevard Laveran, 13013, Marseille, France.
3
Aix Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM 63, CNRS 7278, IRD 198, Inserm 1095, Institut Hospitalo-universitaire Méditerranée Infection, Marseille, France.
4
Centre National de Référence du Paludisme, Marseille, France.
5
Unité de Parasitologie et d'Entomologie, Département des Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, HIA Laveran, Boulevard Laveran, 13013, Marseille, France. bruno.pradines@gmail.com.
6
Aix Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, UM 63, CNRS 7278, IRD 198, Inserm 1095, Institut Hospitalo-universitaire Méditerranée Infection, Marseille, France. bruno.pradines@gmail.com.
7
Centre National de Référence du Paludisme, Marseille, France. bruno.pradines@gmail.com.

Abstract

Anti-malarial drug resistance to chloroquine and sulfadoxine-pyrimethamine has spread from Southeast Asia to Africa. Furthermore, the recent emergence of resistance to artemisinin-based combination therapy (ACT) in Southeast Asia highlights the need to identify new anti-malarial drugs. Doxycycline is recommended for malaria chemoprophylaxis for travel in endemic areas, or in combination with the use of quinine for malaria treatment when ACT is unavailable or when the treatment of severe malaria with artesunate fails. However, doxycycline is not used in young children under 8 years of age due to its contraindication due to the risk of yellow tooth discolouration and dental enamel hypoplasia. Doxycycline was developed after tetracycline and was labelled with the same side-effects as the earlier tetracyclines. However, recent studies report little or no effects of doxycycline on tooth staining or dental enamel hypoplasia in children under 8 years of age. In the United States, the Centers for Disease Control and Prevention have recommended the use of doxycycline for the treatment of acute and chronic Q fever and tick-borne rickettsial diseases in young children. It is time to rehabilitate doxycycline and to recommend it for malaria treatment in children under 8 years of age.

KEYWORDS:

Anti-malarial drug; Antibiotics; Children; Doxycycline; Malaria; Plasmodium falciparum; Prophylaxis; Resistance; Treatment

PMID:
28407772
PMCID:
PMC5390373
DOI:
10.1186/s12936-017-1797-9
[Indexed for MEDLINE]
Free PMC Article

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