BNF for Children 2011-2012

BNFC 2011–2012 5.1.3 Tetracyclines 275Breast-feeding Tetracyclines should not be given towomen who are breast-feeding (although absorptionand therefore discoloration of teeth in the infant isprobably usually prevented by chelation with calciumin milk).Side-effects Side-effects of the tetracyclines includenausea, vomiting, diarrhoea (antibiotic-associated colitisreported occasionally), dysphagia, and oesophagealirritation. Other rare side-effects include hepatotoxicity,pancreatitis, blood disorders, photosensitivity (particularlywith demeclocycline), and hypersensitivity reactions(including rash, exfoliative dermatitis, Stevens-Johnson syndrome, urticaria, angioedema, anaphylaxis,pericarditis). Headache and visual disturbances mayindicate benign intracranial hypertension (discontinuetreatment); bulging fontanelles have been reported ininfants.TETRACYCLINECautions see notes aboveContra-indications see notes aboveHepatic impairment see notes above; max. 1 g dailyin divided dosesRenal impairment see notes abovePregnancy see notes aboveBreast-feeding see notes aboveSide-effects see notes above; also acute renal failure,skin discolorationIndication and doseSusceptible infections see notes above. By mouthChild 12–18 years 250 mg 4 times daily,increased in severe infections to 500 mg 3–4 timesdailyAcne section 13.6.2Non-gonococcal urethritis. By mouthChild 12–18 years 500 mg 4 times daily for 7–14days (21 days if failure or relapse after first course)Tetracycline (Non-proprietary) ATablets, coated, tetracycline hydrochloride 250 mg,net price 28-tab pack = £13.67. Label: 7, 9, 23,counselling, postureDental prescribing on NHS Tetracycline Tablets may beprescribedDEMECLOCYCLINE HYDROCHLORIDECautions see notes above, but photosensitivity morecommon (avoid exposure to sunlight or sun lamps)Contra-indications see notes aboveHepatic impairment see notes above; max. 1 g dailyin divided dosesRenal impairment see notes abovePregnancy see notes aboveBreast-feeding see notes aboveSide-effects see notes above; also reversible nephrogenicdiabetes insipidus, acute renal failureIndication and doseSusceptible infections see notes above. By mouthChild 12–18 years 150 mg 4 times daily or300 mg twice dailyDemeclocycline hydrochloride (Non-proprietary) ACapsules, demeclocycline hydrochloride 150 mg, netprice 28-cap pack = £25.09. Label: 7, 9, 11, 23DOXYCYCLINECautions see notes above; alcohol dependence;photosensitivity reported (avoid exposure to sunlightor sun lamps)Contra-indications see notes aboveHepatic impairment see notes aboveRenal impairment use with caution (avoid excessivedoses)Pregnancy see notes aboveBreast-feeding see notes aboveSide-effects see notes above; also anorexia, drymouth, flushing, anxiety, and tinnitusLicensed use not licensed for use in children under12 yearsIndication and doseSusceptible infections see notes above. By mouthChild 12–18 years 200 mg on first day, then100 mg daily; severe infections (including refractoryurinary-tract infections) 200 mg dailyEarly syphilis. By mouthChild 12–18 years 100 mg twice daily for 14 daysLate latent syphilis. By mouthChild 12–18 years 100 mg twice daily for 28 daysUncomplicated genital chlamydia, non-gonococcalurethritis, pelvic inflammatory diseaseTable 1, section 5.1. By mouthChild 12–18 years 100 mg twice daily for 7 days(14 days in pelvic inflammatory disease)Lyme disease (see also section 5.1.1.3). By mouthChild 12–18 years 100 mg twice daily for 10–14days (for 28 days in Lyme arthritis)Anthrax (treatment or post-exposure prophylaxis)see also section 5.1.12. By mouthChild under 12 years (only if alternative antibacterialcannot be given) 2.5 mg/kg twice daily(max. 100 mg twice daily)Child 12–18 years 100 mg twice dailyAcne section 13.6.25 Infections