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Wednesday, April 06, 2022 10:38:09 AM
Doxycycline freaking wrecked me as a younger kid. I took it for acne and after a few days, it felt like it ate away the lining of my esophagus/upper GI tract.
There's one in every crowd, as we say. This was nature's way of saying we ought not to use broad-spectrum oral antibiotics as maintenance therapy for teenage acne. We probably ought not try to subvert Mother Nature in general. It is not an evolutionary mistake that terrible acne is associated with raging male hormones. It's like a red flag warning for teenage girls, similar to the bright coloring of a poisonous frog. Stay away from this critter because it excretes toxic fluids.
The implications of this are real. When I was in training, we used clindamycin for suspected MRSA infections, but it is no longer a viable option. The last antibiogram I saw from my local hospital showed that less than 50% of MRSA isolates were susceptible to clinda. Given the narrow spectrum of clinda, high prevalence of MRSA resistance severely limits the usefulness of the drug. Bactrim DS (sulfa based) still has decent MRSA coverage for a just a few bucks, then there's doxy for a few dollars more, then there's nothing else by mouth except for Zyvox, which is still in the $1000 range, with insurance, to treat anything.
There are very limited options to treat MRSA infections, especially as an outpatient with oral antibiotics. Doxycycline is an incredibly important drug.
#FreeSequestOx
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