A 10-year-old child with fever, headache, and an eschar in a scrub typhus-endemic region is suspected to have Orientia tsutsugamushi infection. Doxycycline is the drug of choice. The major concern with tetracycline use in children under 8 years is:

• A Irreversible aplastic anemia
• B Nephrogenic diabetes insipidus
• C Permanent tooth discoloration and enamel hypoplasia ✓
• D Tendon rupture

Explanation

Tetracyclines chelate calcium and deposit in developing teeth and bones, causing permanent yellow-brown discoloration and enamel hypoplasia in children under 8 years. This contraindication also applies to pregnant women. Option A describes chloramphenicol toxicity. Option B is a side effect of tetracycline but not the reason for age restriction. Option D is a fluoroquinolone adverse effect.

Reference: Katzung Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.