Todd Suzanne R, Dahlgren F Scott, Traeger Marc S, Beltrán-Aguilar Eugenio D, Marianos Donald W, Hamilton Charlene, McQuiston Jennifer H, Regan Joanna J
Rickettsial Zoonoses Branch, Division of Vectorborne Diseases, Centers for Disease Control and Prevention, Atlanta, GA.
Indian Health Service, Whiteriver, AZ.
J Pediatr. 2015 May;166(5):1246-51. doi: 10.1016/j.jpeds.2015.02.015. Epub 2015 Mar 17.
To evaluate whether cosmetically relevant dental effects occurred among children who had received doxycycline for treatment of suspected Rocky Mountain spotted fever (RMSF).
Children who lived on an American Indian reservation with high incidence of RMSF were classified as exposed or unexposed to doxycycline, based on medical and pharmacy record abstraction. Licensed, trained dentists examined each child's teeth and evaluated visible staining patterns and enamel hypoplasia. Objective tooth color was evaluated with a spectrophotometer.
Fifty-eight children who received an average of 1.8 courses of doxycycline before 8 years of age and who now had exposed permanent teeth erupted were compared with 213 children who had never received doxycycline. No tetracycline-like staining was observed in any of the exposed children's teeth (0/58, 95% CI 0%-5%), and no significant difference in tooth shade (P=.20) or hypoplasia (P=1.0) was found between the 2 groups.
This study failed to demonstrate dental staining, enamel hypoplasia, or tooth color differences among children who received short-term courses of doxycycline at <8 years of age. Healthcare provider confidence in use of doxycycline for suspected RMSF in children may be improved by modifying the drug's label.
评估接受多西环素治疗疑似落基山斑疹热（RMSF）的儿童是否出现与美容相关的牙齿问题。
根据医疗和药房记录摘要，将生活在RMSF高发的美国印第安人保留地的儿童分为多西环素暴露组或非暴露组。持牌、经过培训的牙医检查每个孩子的牙齿，并评估可见的染色模式和釉质发育不全情况。用分光光度计评估牙齿的客观颜色。
将平均在8岁前接受1.8个疗程多西环素治疗且现在有恒牙萌出的58名儿童与213名从未接受过多西环素治疗的儿童进行比较。在任何暴露组儿童的牙齿中均未观察到四环素样染色（0/58，95%CI 0%-5%），两组之间在牙齿色度（P=0.20）或发育不全（P=1.0）方面未发现显著差异。
本研究未能证明8岁以下接受短期多西环素治疗的儿童存在牙齿染色、釉质发育不全或牙齿颜色差异。修改该药物的标签可能会提高医疗服务提供者对在儿童中使用多西环素治疗疑似RMSF的信心。
