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Doxycycline monograph

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    Doxycycline monograph


    から化学的に合成されたテトラサイクリン系の抗菌薬である。日本での先発品は、ファイザーのビブラマイシン。グラム陽性菌やグラム陰性菌、リケッチア、マイコプラズマ、クラミジアなどへ、広い抗菌作用を示す。細菌の蛋白合成を阻害し、静菌性の抗生物質に分類される。特に脂溶性が強く、経口投与での吸収が極めて良好、組織内移行も良好で長時間持続する。一般的な副作用は、消化器系(食欲不振や悪心、嘔吐、腹痛、下痢など)と皮膚障害(発疹や蕁麻疹、光線過敏など)である。 ドキシサイクリンの抗菌作用の作用機序は、他のテトラサイクリン系抗菌薬と同様に、細菌に取り込まれたものが、細菌の持つリボソームの30Sサブユニットに可逆的ながら比較的強く結合し、タンパク質の合成に阻害をかけることによる。すなわち、細菌のリボソームを一時的に使用不能にして、細菌に必要なタンパク質を生合成できないようにすることによって、細菌の増殖を一時的に阻止する。なお、細菌などの原核生物のリボソームは30Sと50Sサブユニットから成っているのに対して、ヒトなど真核生物のリボソームは40Sと60Sであるため、真核生物のリボソームに対しては、その機能を効果的に阻害することは難しい。したがって、ドキシサイクリンは原核生物に対して選択毒性を持つ。ドキシサイクリンに対して耐性を持たない細菌に対する最小発育阻止濃度(MIC)は、0.03 (μg/ml)から0.12 (μg/ml)程度である。ただし、ドキシサイクリンに対して耐性を持つ細菌も存在する。 ドキシサイクリンをヒトに対して空腹時に経口投与した場合の吸収は速やかであり、最高血中濃度到達時間は約3時間とされる。ところで、一般的なテトラサイクリン系の抗菌薬は、その化学構造からカルシウムイオンなどと難溶性の複合体を生成しやすく、例えばカルシウムを多く含む食品と同時に摂取すると、吸収が阻害される。しかし、ドキシサイクリンの場合は他のテトラサイクリン系の抗菌薬とは異なり、乳汁や食物と同時に摂取しても、最高血中濃度到達時間こそ空腹時よりも遅くなるものの、ドキシサイクリンの吸収自体には支障が起こらない ドキシサイクリンは経口血糖降下薬であるスルフォニルウレア系薬剤(SU薬)の効果を増強するため、SU剤との併用は注意が必要であることが能書に明記されているが、これはドキシサイクリンがSU剤の効果を増強するとされるためである。これについて最近では、ドキシサイクリンがインスリンの半減期を延長させたりアドレナリンの作用を阻害することにより間接的にインスリンの効果を増強させるためと考えられており、SU薬への直接的な相互作用ではなく間接的な増強作用とされている。また、膵外作用として末梢組織でのインスリン感受性を増強し糖代謝を改善させることも推測されている。 ペニシリン系: ペニシリンG, アンピシリン, バカンピシリン, レナンピシリン, シクラシリン, アモキシシリン, ピブメシリン, アスポキシシリン, クロキサシリン, ピペラシリン, メチシリン; 複合ペニシリン系薬: アンピシリン, クロキサシリン; βラクタマーゼ阻害剤配合ペニシリン系薬: アンピシリン, スルバクタム, クラブラン酸, アモキシシリン, ピペラシリン, タゾバクタム; セフェム系: セファゾリン, セファロンチン, セファレキシン, セファトリジン, セフロキサジン, セファクロル, セファドロキシル, セフォチアム, セフメタゾール, フロモキセフ, セフミノックス, セフブペラゾン, セフロキシム, アキセチル, セフジニル, セフジトレン, ピボキシル, セフテラム, ピボキシル, セフポドキシム, プロキセチル, セフカペン, ピボキシル, セフォタキシム, セフトリアキソン, セフォペラゾン, セフメノキシム, セフタジジム, セフチブテン, セフィキシム, セフォジジム, ラタモキセフ, セフチゾキシム, セフピロム, セフォゾプラン, セフェピム; βラクタマーゼ阻害剤配合セフェム系: セフォペラゾン, スルバクタム; カルバペネム系: イミペネム, シラスタチン, パニペネム, ベタミプロン, メロペネム, ビアペネム, ドリペネム, テビペネム; モノバクタム系: アズトレオナム, スルバクタム, タゾバクタム, カルモナム; ペネム系: ファロペネム. 第2世代キノロン: シプロフロキサシン, オフロキサシン, エノキサシン, ロメフロキサシン, ナジフロキサシン, ノルフロキサシン, ペフロキサシン, ルフロキサシン; 第3世代キノロン(フルオロキノロン): レボフロキサシン, グレパフロキサシン, パズフロキサシン, スパルフロキサシン, テマフロキサシン, トスフロキサシン ; 第4世代キノロン(エイトメトキシキノロン): スパルフロキサシン, ガチフロキサシン, モキシフロキサシン, ガレノキサシン, シタフロキサシン, ジェミフロキサシン, クリナフロキサシン, プルリフロキサシン, トロバフロキサシン, アラトロフロキサシン. cytotec uses Search or browse the over 2,300 drug guides by drug name to view trusted, reliable drug guides written for the patient and available on demand. PDR for Patients combines the benefits, as well as the safety information for the drugs chosen, helping patients understand why they are taking the medication and the benefits of adhering to their regimen. View or print the information you need when you need it.

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    In addition to the general indications for all members of the tetracycline antibiotics group, doxycycline is frequently used to treat Lyme disease, chronic prostatitis, sinusitis, pelvic inflammatory disease, Moraxella catarrhalis, Brucella melitensis, Chlamydia pneumoniae, and Mycoplasma pneumoniae are generally susceptible to doxycycline, while some Haemophilus spp., Mycoplasma hominis, and Pseudomonas aeruginosa have developed resistance to varying degrees. Some Gram-positive bacteria have developed resistance to doxycycline. Up to 44% of Streptococcus pyogenes and up to 74% of S. faecalis specimens have developed resistance to the tetracycline group of antibiotics. When bacteriologic testing indicates appropriate susceptibility to the drug, doxycycline may be used to treat these infections caused by Gram-positive bacteria: The World Health Organization Guidelines states that the combination of doxycycline with either artesunate or quinine may be used for the treatment of uncomplicated malaria due to Plasmodium falciparum or following intravenous treatment of severe malaria. Doxycycline kills the symbiotic Wolbachia bacteria in the reproductive tracts of parasitic filarial nematodes, making the nematodes sterile, and thus reducing transmission of diseases such as onchocerciasis and elephantiasis. Doxycycline has been used successfully to treat sexually transmitted, respiratory, and ophthalmic infections. Are one of the world’s most widely used medical information resources. The Manuals are committed to making the best current medical information accessible by up to 3 billion health care professionals and patients on every continent by 2020. We believe that health information is a universal right and that every person is entitled to accurate and accessible medical information. We have a responsibility to protect, preserve and share the best current medical information to enable more informed decisions, enhance relationships between patients and professionals, and improve health care outcomes around the world. That’s why we are making the Merck Manuals and the MSD Manuals available for free in digital form in multiple languages to professionals and patients around the world. Merck and Co., Inc., Kenilworth, NJ, USA (known as MSD outside the US and Canada) is a global healthcare leader working to help the world be well. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world.

    Doxycycline monograph

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