A 55-year-old man on maintenance hemodialysis for chronic kidney disease requires treatment for scrub typhus. Which tetracycline can be prescribed without any adjustment for his renal function?
- A Tetracycline
- B Doxycycline ✓
- C Oxytetracycline
- D Demeclocycline
Correct answer: B. Doxycycline
Explanation
Doxycycline is unusual among tetracyclines because it is predominantly eliminated by nonrenal routes, being secreted into the intestinal lumen and inactivated in feces, so no dose reduction is needed in renal failure. Tetracycline and oxytetracycline are primarily renally cleared and accumulate in uremia, worsening nitrogen retention. Demeclocycline is renally cleared and also causes nephrogenic diabetes insipidus, compounding problems in kidney disease.
Reference: Katzung Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.