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Higher concentrations can be achieved after intravenous use; concentrations may be higher in women than in men. The tetracyclines are widely distributed throughout the body tissues and fluids. Concentrations in CSF are relatively low, but may be raised if the meninges are inflamed, and small amounts appear in saliva and in the fluids of the eye; higher concentrations are achieved with more lipid-soluble derivatives such as minocycline and doxycycline.
Tetracyclines are retained at sites of new bone formation and recent calcification and in developing teeth. The tetracyclines have been classified in terms of their duration of action in the body, although the divisions appear to overlap somewhat. The tetracyclines are excreted in the urine and in the faeces. Urinary excretion is increased if urine is alka-linised. The tetracyclines are excreted in the bile, where concentrations 5 to 25 times those in plasma can occur. Since there is some enterohepatic reabsorption complete elimination is slow. Considerable quantities occur in the faeces after oral doses and lesser amounts after injection.
Tetracyclines are slowly removed by haemodialysis, except for doxycycline which is not removed; they are not where I Can Buy Sumycin No Prescription by peritoneal dialysis. They are widely used as part of regimens for pelvic inflammatory disease. A tetracychne is often used with fluid and electrolyte replacement in the treatment of cholera, and is where I Can Buy Sumycin No Prescription the treatment of choice in relapsing fever and in the early stages of Lyme disease.
Tetracyclines may be of benefit in the treatment of melioidosis. Opinions differ as to their value in listeriosis. There are now where I Can Buy Sumycin No Prescription few areas where tetracycline-resistant gonococci are uncommon, which limits the value of tetracyclines in gonorrhoea, but they are often given with antigonorrhoeal therapy to treat concomitant chlamydial infections, and they retain some value in the prophylaxis of neonatal gonococcal conjunctivitis by topical application. For details of all these infections and their treatment, see under Choice of Antibacterial. Tetracyclines are also used in the oral treatment of acne and rosacea see Skin Disorders, below.
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Higher doses, up to 4 g daily, have occasionally been given to adults with severe infection, but increase the risk of adverse effects. It is also sometimes given orally with other tetracydine derivatives. Tetracychne hydrochloride has been given by slow intravenous infusion or by intramuscular injection in severe infections.
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