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2013 Advisory : Doxycycline Shortage and Treatment of Sexually Transmitted Infections


  • Doxycycline tablets and capsules are currently available in limited supplies.
  • CDC-recommended alternative regimens not containing doxycycline widely available, impact on patients minimal

January 29, 2013

Dear Colleagues,

On January 18, 2013, the Food and Drug Administration (FDA) reported a shortage of doxycycline on January 18, 2013. Doxycycline is a recommended therapy for some sexually transmitted infections and syndromes including chlamydia, nongonococcal urethritis, epididymitis and pelvic inflammatory disease. It is also an alternative therapy for syphilis in patients with a penicillin allergy. Doxycycline tablets/capsules are currently available in limited supplies. For additional information about the availability of doxycycline, visit the FDA Drug Shortage Website http://www.fda.gov/Drugs/DrugSafety/DrugShortages/ucm050792.htm Other CDC recommended and additional alternative regimens are listed below and outlined in the 2010 STD Treatment Guidelines http://www.cdc.gov/std/treatment/2010/default.htm

Chlamydia and Nongonococcal urethritis
Azithromycin 1 g orally in a single dose

Gonorrhea
Ceftriaxone 250 mg IM in a single dose
PLUS
Azithromycin 1 g orally in a single dose

Syphilis (penicillin allergic)
Primary or secondary syphilis
Tetracycline 500 mg orally four times daily for 14 days

Late latent syphilis
Tetracycline 500 mg orally four times daily for 28 days

Epididymitis
Ceftriaxone 250 mg IM in a single dose
PLUS
Tetracycline 500 mg four times daily for 10 days

Pelvic Inflammatory Disease*
Ceftriaxone 250 mg IM in a single dose
PLUS
Clindamycin 450 mg orally four times daily for 14 days
WITH OR WITHOUT
Metronidazole 500 mg orally twice a day for 14 days
*see STD Treatment Guidelines for additional regimens

Sincerely,

Susan Blank, MD MPH
Assistant Commissioner
Bureau of STD Control

Resources

Centers for Disease Control and Prevention Doxycycline Shortage Announcement
http://www.cdc.gov/std/treatment/doxycyclineShortage.htm

Centers for Disease Control and Prevention 2010 STD Treatment Guidelines
http://www.cdc.gov/std/treatment/2010/default.htm

Centers for Disease Control and Prevention STD Guidance
http://www.cdc.gov/std/default.htm

FDA Drug Shortage Website
http://www.fda.gov/Drugs/DrugSafety/DrugShortages/ucm050792.htm


Posted 02-07-2013 at 4:01PM

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