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TETRACYCLINE
➢ Introduction
• These are a class of antibiotics having a nucleus of four cyclic
rings
• All tetracyclines are obtained from soil actinomycetes. The first to
be introduced was chlortetracycline in 1948 under the name
aureomycin
• They are also called broad spectrum antibiotics.
• Mechanism of action- The tetracyclines are primarily
bacteriostatic. They inhibit protein synthesis by binding to 30S
ribosomes in susceptible organisms
➢ Classification
A. On the basis of duration

B. On the basis of origin

i) Natural- Teracyline, Chlorteracycline, Demeclocycline
ii) Semisynthetic- Doxycycline, Lymecycline, Meclocycline
iii) Prodrug- Rolitetracycline, Lymecycline, Pipacycline
➢ Dose
i) Tigecycline-Dose: 100 mg loading dose, followed by 50 mg 12 hourly by i.v. infusion over 30–60 min, for 5–
14 days.
ii) Demeclocycline
For bacterial or protozoal infections:
▪ Adults and teenagers—150 milligrams every six hours; or 300 mg every twelve hours. Gonorrhea
is treated with 600 mg on the first day, then 300 mg every twelve hours for four days.
▪ Children older than 8 years of age—Dose is based on body weight. The usual dose is 1.65 to 3.3
mg per kilogram of body weight every six hours; or 3.3 to 6.6 mg per kg of body weight every
twelve hours.
▪ Infants and children 8 years of age and younger—Tetracyclines usually are not used in young
children because tetracyclines can permanently stain teeth.

iii) Doxycycline
➢ For bacterial or protozoal infections:
▪ Adults and children older than 8 years of age who weigh more than 45 kilograms—100
milligrams every twelve hours the first day, then 100 mg once a day or 50 to 100 mg every
twelve hours.
▪ Children older than 8 years of age who weigh 45 kg or less—Dose is based on body weight. The
usual dose is 2.2 mg per kg of body weight two times a day on the first day, then 2.2 to 4.4 mg
per kg of body weight once a day or 1.1 to 2.2 mg per kg of body weight twice a day.
▪ Infants and children 8 years of age and younger—Tetracyclines are usually not used in young
children because tetracyclines can permanently stain teeth.
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➢ For the prevention of malaria:

▪ Adults and teenagers—100 mg once a day. You should take the first dose one or two days
before travel to an area where malaria may occur, and continue taking the medicine every day
throughout travel and for four weeks after you leave the malarious area.
▪ Children older than 8 years of age—Dose is based on body weight. The usual dose is 2 mg per kg
of body weight once a day. You should take the first dose one or two days before travel to an
area where malaria may occur, and continue taking the medicine every day throughout travel
and for four weeks after you leave the malarious area.
▪ Infants and children 8 years of age and younger—Tetracyclines are usually not used in young
children because tetracyclines can permanently stain teeth.
iv) For minocycline
• For bacterial or protozoal infections:
o Adults and teenagers—200 milligrams at first, then 100 mg every twelve hours; or 100 to 200
mg at first, then 50 mg every six hours.
o Children older than 8 years of age—Dose is based on body weight. The usual dose is 4 mg per
kilogram of body weight at first, then 2 mg per kg of body weight every twelve hours.
o Infants and children 8 years of age and younger—Tetracyclines are usually not used in young
children because tetracyclines can permanently stain teeth.
v) For oxytetracycline
• For bacterial or protozoal infections:
o Adults and teenagers—250 to 500 milligrams every six hours.
o Children older than 8 years of age—Dose is based on body weight. The usual dose is 6.25 to 12.5
mg per kilogram of body weight every six hours.
o Infants and children 8 years of age and younger—Tetracyclines are usually not used in young
children because tetracyclines can permanently stain teeth.
vi) For tetracycline
• For bacterial or protozoal infections:
o Adults and teenagers—250 to 500 milligrams every six hours; or 500 mg to 1 gram every twelve
hours. Gonorrhea is treated with 1.5 grams as the first dose, then 500 mg every six hours for
four days.
o Children older than 8 years of age—Dose is based on body weight. The usual dose is 6.25 to 12.5
mg per kilogram of body weight every six hours; or 12.5 to 25 mg per kg of body weight every
twelve hours.
o Infants and children 8 years of age and younger—Tetracyclines are usually not used in young
children because tetracyclines can permanently stain teeth.

➢ Indication
1. Empirical therapy- Tetracyclines are often employed when the nature and sensitivity of the infecting organism
cannot be reasonably guessed.
2. Tetracyclines are the first choice drugs:
(a) Venereal diseases:
• Chlamydial nonspecific urethritis
• Lymphogranuloma venereum
• Granuloma inguinale
(b) Atypical pneumonia
(c) Cholera
(d) Brucellosis
(e) Plague
(f) Relapsing fever
(g) Rickettsial infections
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3. Tetracyclines are second choice drugs:

for tetanus, anthrax, actinomycosis and Listeria infections for gonorrhoea, in patients allergic to penicillin
➢ Contraindication
• Hypersensitivity
• Pregnancy
• Lactation
• Children youner than 9 year

SULFONAMIDE (SULFA DRUGS)

• Sulfonamides were the first antimicrobial agents (AMAs) effective against pyogenic(pus forming) bacterial
infections.
• All sulfonamides may be considered to be derivatives of sulfanilamide (p-aminobenzene sulfonamide).

• Mechanism of action Many bacteria synthesize their own folic acid (FA) of which paminobenzoic acid (PABA) is a
constituent, and is taken up from the medium. sulfonamides, being structural analogues of PABA, inhibit
bacterial folate synthase, so that FA is
• not formed and a number of essential metabolic reactions suffer
• Triple sulfa- It is the combination of 3 sulfonamides together. Triple sulfa vaginal is used to treat vaginal
infections caused by the bacteria Gardnerella vaginalis
• The fixed dose combination of trimethoprim and sulfamethoxazole is called cotrimoxazole.

➢ Classification
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➢ Dose

➢ Indication

➢ Contraindication
• Hypersenstivity
• Renal impairments
• Pregnancy
• Infants

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