Tetracycline -- Common Information
Tetracycline
Tetracyclines are oral antibiotics often used to treat skin diseases.
Tetracycline, or one of its derivatives (doxycycline and minocycline are also available in New Zealand), are most often used for acne, rosacea or perioral dermatitis and are frequently effective .
However tetracyclines only suppress these conditions, they do not cure them. Therefore these antibiotics need to be continued until the disease runs it course, often months or years. Long-term treatment with tetracycline is remarkably safe; there has been over 30 years experience with the medication.
Acne suitable for tetracycline
|
|
)
Dosage
Patients differ in the amount of tetracycline they need. A full daily dose of tetracycline is generally prescribed for the first few weeks or months to see how well it controls the skin problem. This full dose should be continued for most patients with acne. However, those with rosacea may be able to reduce their dose at approximately monthly intervals. There's a lag period of one to three weeks between the change in dosage and its effect on skin. If the skin problem becomes worse, return to the previous higher dosage and continue on it.
Precautions
Tetracycline should be stored in a cool place out of direct sunlight. Outdated capsules or tablets should not be taken as they may cause kidney damage.
Tetracycline must not be taken by pregnant or breast-feeding women, or by children under twelve years, because it discolours growing teeth.
However, even when taken for months or years, tetracycline has few side effects. Allergy is uncommon; it results in various types of skin rash, and rarely, liver disease. Minocycline may occasionally cause severe headaches and has been reported to precipitated lupus.
Tetracycline should be taken with a glass of water on an empty stomach, half an hour before, or two hours after meals. This is because food prevents absorption of tetracycline into the bloodstream. Some people find this inconvenient, and others get indigestion unless it is taken with food. Minocycline and doxycycline are not affected by food and can be taken at mealtime.
Tetracycline may make the skin more sensitive to sunlight; this effect depends on the variety of tetracycline and the amount taken. If unexpected sunburn does occur, take the medication in the evening and avoid excessive sun exposure.
Because of fewer bacteria in the vagina, in women, tetracycline occasionally produces thrush, an overgrowth of Candida yeasts. This results in genital irritation and discharge. With appropriate treatment of the thrush, the antibiotics can usually be continued.
Effect on contraceptives
There is little evidence that tetracyclines reduce the efficacy of the oral contraceptive pill unless they cause gastrointestinal upset. However, to be absolutely safe, extra precautions should be taken, particularly in the first four weeks of starting the antibiotics. Discuss this with your doctor.
If you develop side affects, advise your doctor. You may need to stop taking tetracycline or change brand.
Related information
Thrush
Vulvovaginal candidiasis
Vulvovaginal candidiasis is a yeast infection of the vulva and vagina.
Most women notice from time to time that they have a discharge from the vagina. This is a normal process which keeps the mucous lining of the vagina moist. The discharge is usually clear but may dry on underclothes leaving a faint yellowish mark. This type of discharge does not require any medication.
Other causes of vaginal discharge include infection with:
-
Candida (a yeast)
-
Trichomonas (a small parasite)
-
Gardnerella (the chance association of two kinds of bacteria which live in the vagina).
About 10% of non-pregnant women aged 15 to 55 harbor the yeast Candida in the vagina but most have no symptoms and it is harmless to them. In a few women vaginal candidacies causes a heavy white curd-like vaginal discharge, a burning sensation in the vagina and vulva and/or an itchy rash. This is also known as thrush or monilia.
Thrush occurs most commonly with:
-
Pregnancy
-
A course of broad spectrum antibiotics
-
Dabetes
-
Iron deficiency anaemia
-
Immunological deficiency
-
On top of another skin condition, often psoriasis
-
Other illness
It may sometimes be transmitted or aggravated by sexual intercourse.
The doctor diagnoses the condition by inspecting the affected area and taking a swab. In recurrent cases the swab should be repeated after treatment to see whether yeast is still present.
Swab results can be misleading however, because the yeast can be present without causing symptoms and it can only be cultured if a certain amount is present.
Some women appear to be hypersensitive to the organism, so although its presence cannot be proven by the laboratory, the yeast is still responsible for the subject's symptoms.
Treatment
If you have vulval or vaginal candidacies, you can obtain specific anticandidal treatment from your chemist. If this is ineffective or symptoms recur, see your doctor for examination and advice.
There are a variety of effective treatments for candidacies. Topical antifungal pessaries or vaginal tablets are usually recommended - sometimes a single treatment is all that is necessary. In addition anti-yeast cream may need to be applied to the vulva or oral antifungal medicines used.
The creams can be used safely in pregnancy, but the tablets are best avoided.
Not all itchy genital rashes are due to candida, so if treatment is unsuccessful it may because you have another reason for pruritus vulvae.
Recurrent Candidiasis
Occasionally the fungal infection persists despite adequate conventional therapy.
The following measures can be helpful:
-
Cotton underwear and loose fitting clothing - avoid pantihose.
-
Wipe from in front backwards and wash after going to the toilet.
-
Treat before each menstrual period and before antibiotic therapy.
-
Cut out sugary foods.
-
Eat acidophilus yogurt (but this sometimes aggravates thrush).
-
Sterilize panties by boiling, hypochlorite (bleach) or microwave.
-
Prolonged courses of topical antifungal agents (but these may cause dermatitis).
-
Oral antifungal treatment to remove yeasts in the bowel and elsewhere.
-
Treatment of sexual partner.
Oral antifungal treatment with itraconazole or fluconazole is very effective. It is usually prescribed intermittently (e.g. once a month) but the dose and frequency is quite variable, depending on the severity of symptoms. Oral antifungal agents are unsuitable in pregnancy.
Related information