La doxycycline, membre de la famille des tétracyclines, agit par inhibition de la fixation de l’ARNt sur la sous-unité 30S du ribosome, empêchant l’élongation de la chaîne peptidique. Elle se caractérise par un spectre très large incluant bactéries atypiques, rickettsies, chlamydiae et spirochètes. Sa biodisponibilité digestive est excellente, mais elle est diminuée en cas d’ingestion simultanée de sels de calcium, fer ou magnésium. La doxycycline diffuse bien dans les tissus et possède une demi-vie longue, permettant des administrations biquotidiennes. Elle est éliminée principalement par voie biliaire. Les précautions concernent le risque de photosensibilisation, d’hyperpigmentation dentaire et de troubles digestifs. Dans les recommandations cliniques, la mention doxycycline sans ordonnance est souvent accompagnée de rappels sur la nécessité d’éviter son usage chez l’enfant et la femme enceinte, ainsi que sur la surveillance des traitements prolongés.
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