A 70-year-old man with creatinine clearance of 15 mL/min requires therapy for Legionella pneumonia. Which tetracycline can be given without dose adjustment because it is eliminated predominantly by nonrenal routes?

• A Tetracycline
• B Oxytetracycline
• C Demeclocycline
• D Doxycycline ✓

Explanation

Doxycycline is unique among tetracyclines because it is largely excreted into the feces and inactive conjugates appear in urine without significant active drug accumulation. It does not accumulate in renal failure and needs no adjustment, unlike tetracycline, oxytetracycline, and demeclocycline, which are renally cleared and can worsen azotemia through their antianabolic effect on protein synthesis.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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