Evidence map›Paper›PMID 26680308›Full record

SynthesisExpert opinion on drug safety2016

Revisiting doxycycline in pregnancy and early childhood--time to rebuild its reputation?

Ruby Cross, Clare Ling, Nicholas P J Day, Rose McGready, Daniel H Paris

Open access · hybridAbstract readComparative StudySystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Expert opinion on drug safety, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 97 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
97citing papers in PubMed, 10 pooled it
7.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

97 citing papers in PubMed, 10 syntheses or guidelines pooled it, 196 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Leptospirosis in pregnancy: A systematic review.PLoS neglected tropical diseases · 2021
    Pooled it
  9. Estimating the burden of scrub typhus: A systematic review.PLoS neglected tropical diseases · 2017
    Pooled it
  10. Pooled it
  11. Trial
  12. A Prospective, Open-label, Randomized Trial of Doxycycline Versus Azithromycin for the Treatment of Uncomplicated Murine Typhus.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019
    Trial
  13. Review
  14. Article
  15. Review
  16. East Asia as a sentinel: risk-stratified corticosteroid therapy for paediatric macrolide-resistantEuropean respiratory review : an official journal of the European Respiratory Society · 2026
    Review
  17. Review
  18. Review
  19. Article
  20. Article

37 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

Ruby Crossa Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine , Mahidol University , Mae Sot , Tak , Thailand.
Clare Linga Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine , Mahidol University , Mae Sot , Tak , Thailand.
Nicholas P J Dayb Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine , Mahidol University , Bangkok , Thailand.
Rose McGreadya Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine , Mahidol University , Mae Sot , Tak , Thailand.
Daniel H Parisb Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine , Mahidol University , Bangkok , Thailand.
Angkor Hospital for Children · KHMahidol Oxford Tropical Medicine Research Unit · TH

Funding

Wellcome Trust
6 · The paper itself

Abstract

introductionDoxycycline is highly effective, inexpensive with a broad therapeutic spectrum and exceptional bioavailability. However these benefits have been overshadowed by its classification alongside the tetracyclines - class D drugs, contraindicated in pregnancy and in children under 8 years of age. Doxycycline-treatable diseases are emerging as leading causes of undifferentiated febrile illness in Southeast Asia. For example scrub typhus and murine typhus have an unusually severe impact on pregnancy outcomes, and current mortality rates for scrub typhus reach 12-13% in India and Thailand. The emerging evidence for these important doxycycline-treatable diseases prompted us to revisit doxycycline usage in pregnancy and childhood. AREAS COVERED: A systematic review of the available literature on doxycycline use in pregnant women and children revealed a safety profile of doxycycline that differed significantly from that of tetracycline; no correlation between the use of doxycycline and teratogenic effects during pregnancy or dental staining in children was found. EXPERT OPINION: The change of the US FDA pregnancy classification scheme to an evidence-based approach will enable adequate evaluation of doxycycline in common tropical illnesses and in vulnerable populations in clinical treatment trials, dosage-optimization pharmacokinetic studies and for the empirical treatment of undifferentiated febrile illnesses, especially in pregnant women and children.

Indexed as

Age FactorsAnimalsAnti-Bacterial AgentsBacterial InfectionsChildChild, PreschoolContraindicationsDoxycyclineFemaleHumansInfantInfant, NewbornPregnancyPregnancy Complications, InfectiousPregnancy OutcomeAnti-Bacterial AgentsDoxycyclineDoxycyclinemajor congenital anomaliesmurine typhusOrientia tsutsugamushipregnancyprenatal exposureRickettsia typhirickettsiosisscrub typhusside effectsteratogenicitytetracyclinetooth discolourationundifferentiated fever

Identifiers

PMID26680308
PMCPMC4898140
OpenAlexW2239705084

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.