Doxycycline
| Evidence Level: L5 | Predicted Indications: 10 |
Table of Contents
- Doxycycline
- Pharmacist Assessment Report
- Doxycycline: From Bacterial Infections (Bronchitis, Acne, Pneumonia) to Punctate Epithelial Keratoconjunctivitis
- One-Sentence Summary
- Quick Overview
- Why is This Prediction Reasonable?
- Clinical Trial Evidence
- Literature Evidence
- India Market Information
- Safety Considerations
- Conclusion and Next Steps
- Disclaimer
Doxycycline: From Bacterial Infections (Bronchitis, Acne, Pneumonia) to Punctate Epithelial Keratoconjunctivitis
One-Sentence Summary
Doxycycline is a tetracycline-class antibiotic. It is used for bronchitis, bacterial pneumonia, acne, anthrax, gonorrhoea and a range of other bacterial infections. The TxGNN model predicts it may be useful for punctate epithelial keratoconjunctivitis. Evidence is thin: no clinical trials and 1 publication (a 1992 case report) support this direction.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Bronchitis, acne, bacterial pneumonia, anthrax, gonorrhoea and other bacterial infections (from the knowledge-graph indication list; no approved-indication text is recorded for the Indian licences) |
| Predicted New Indication | Punctate epithelial keratoconjunctivitis |
| TxGNN Prediction Score | 0.9994 |
| Evidence Level | L5 |
| India Market Status | Listed in a compiled Indian medicine price dataset (at least 20) – CDSCO approval status is not included in this data |
| Number of Listed Products | at least 20 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Currently, detailed mechanism of action data is not available. Based on known information, doxycycline is a broad-spectrum tetracycline antibiotic. Its efficacy in bacterial infections, including those caused by Chlamydia trachomatis, is established, and mechanistically it may be applicable to punctate epithelial keratoconjunctivitis.
Persistent superficial punctate keratitis can follow chlamydial follicular conjunctivitis, an infection doxycycline treats. Doxycycline is also known for anti-inflammatory and matrix metalloproteinase (MMP)-inhibiting effects that could help the ocular surface. This benefit is inferred, not demonstrated.
The only supporting report describes keratitis that appeared after the infection was treated with oral tetracycline or doxycycline. That is indirect evidence, and it does not show that doxycycline treats the keratitis itself.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 1424659 | 1992 | Case report | Cornea | Two patients with chlamydial follicular conjunctivitis were treated with oral tetracycline or doxycycline, and the follicles resolved. Both then developed recurrent, bilateral punctate epithelial keratitis, and one had anterior stromal edema. |
India Market Information
Twenty single-ingredient doxycycline licences are valid, and none are cancelled. Oral tablets and capsules and injectable vials are all available. The licence records do not include approved-indication text. Five of the 20 are shown below.
| Authorization Number | Product Name | Dosage Form | Manufacturer |
|---|---|---|---|
| 178608 | Pydox 100mg Tablet | Strip of 10 tablets | Pifer Pharmaceuticals Pvt Ltd |
| 13789 | Amdoxy Capsule | Strip of 10 capsules | Ampira Biotechnics Pvt Ltd |
| 58835 | Doxicip LB Capsule | Strip of 10 capsules | Cipla Ltd |
| 59833 | Doxytab 100mg Tablet | Strip of 8 tablets | Intas Pharmaceuticals Ltd |
| 68326 | Dcyline 100mg Injection | Vial of 1 injection | Dr. Edwin Lab |
Safety Considerations
- Contraindications (knowledge-graph disease associations, not label text): Clostridium difficile colitis, perinatal necrotizing enterocolitis, and dyskinesia of the esophagus.
- Drug Interactions: 471 interactions are recorded. Major-level examples include isotretinoin, acitretin and aminolevulinic acid. Moderate-level examples include aluminum hydroxide, aminophylline, amoxicillin, ampicillin and bedaquiline.
Please refer to the package insert for full warnings and contraindications.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction score is high, but the only evidence is a single 1992 case report that describes keratitis after an infection, not a response to doxycycline. No trials exist, and the mechanistic link is inferred.
To proceed, the following is needed:
- Mechanism of action data
- Package insert warnings and contraindications for Indian-market products, which are required for safety screening
- Controlled clinical evidence (trials or well-designed studies) of doxycycline in punctate epithelial keratoconjunctivitis
- A clear route and formulation rationale for ocular use, since the Indian products are oral and injectable
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.