title: Role of doxycycline in Clostridium difficile infection acquisition.
abstract: OBJECTIVE
  To evaluate and review the literature surrounding the potential protective benefit of tetracyclines, particularly doxycycline, in reducing Clostridium difficile infection (CDI) acquisition.
  
  
  METHODS
  MEDLINE/PubMed, Google Scholar, and International Pharmaceutical Abstracts were searched through January 2014 using the search terms doxycycline, tetracycline, and Clostridium difficile.
  
  
  METHODS
  Relevant studies, case reports, and review articles were screened for inclusion. Bibliographies of articles were extensively reviewed for additional sources.
  
  
  RESULTS
  Doxycycline is a second-generation tetracycline antibiotic indicated for use in a variety of clinical syndromes and has activity against aerobic Gram-positive and -negative, anaerobic, and atypical bacteria as well as protozoan parasites. Although not used therapeutically to treat CDI, doxycycline may prevent or attenuate the virulence factors of toxigenic C difficile. Current literature does not indicate an increased risk of development of CDI with doxycycline use. In 3 retrospective studies, the use of doxycycline was associated with a protective effect.
  
  
  CONCLUSIONS
  Doxycycline has been shown to have potential protective effects against the development of CDI. Although further randomized placebo-controlled studies are needed, available data suggest that the use of doxycycline in place of alternative antimicrobials, when appropriate, may be a useful antimicrobial stewardship strategy aimed at reducing the incidence of CDI.
authors.affiliation: Pacific University Oregon School of Pharmacy, Hillsboro, OR, USA.
authors.forename: R Brigg
authors.initials: RB
authors.lastname: Turner
authors.forename: Carmen B
authors.initials: CB
authors.lastname: Smith
authors.forename: Jay L
authors.initials: JL
authors.lastname: Martello
authors.forename: Douglas
authors.initials: D
authors.lastname: Slain
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000517:prevention & control*; D004318:Doxycycline / Q000627:therapeutic use*; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents; D004318:Doxycycline
keywords: Clostridium difficile infection; doxycycline; superinfection