CDC offers recommendations on doxycycline shortage

In response to recent shortages of the antibiotic doxycycline, the CDC issued recommendations to clinicians about appropriate use of the drug when availability is limited.

According a health advisory of June 12, the CDC recommends the following:

• Doxycycline should be used to treat suspected rickettsial infections; no alternatives can be recommended that have the same proven degree of efficacy in limiting fatal outcome. Because treatment delay can result in adverse or fatal outcome, planning for doxycycline availability is essential.
• Doxycycline is the recommended drug for prophylaxis of Lyme disease; alternatives have not been tested for efficacy. Clinicians should be judicious in its use following a tick bite.
• Doxycycline should still be used for the prophylaxis and treatment of malaria according to the standard recommendations.
• Alternatives exist for the treatment of sexually transmitted diseases and Lyme disease. Clinicians should use clinical judgment in making treatment and prophylactic decisions.

Doxycycline is currently available from most manufacturers, and no manufacturers are currently reporting shortages of intravenous doxycycline hyclate or oral suspension doxycycline calcium, according to the FDA. The agency has received reports of shortage from some, but not all, manufacturers of some dosages and forms of doxycycline hyclate and doxycycline monohydrate.

Clinicians should ensure they have access to doxycycline for the listed indications, and advance planning is essential to ensure treatment is not delayed, the CDC said. Those who encounter difficulty ordering doxycycline or increased pricing from their usual suppliers should contact alternate distributors, drug manufacturers, or their state health department to inquire about other procurement options. For additional information about the availability of doxycycline, visit the FDA Drug Shortage website or the American Society of Health-System Pharmacists website.