Tao Rachel E, Prajapati Stuti, Pixley Jessica N, Grada Ayman, Feldman Steven R
Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC 27104, USA.
Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA.
Antibiotics (Basel). 2023 Jul 5;12(7):1152. doi: 10.3390/antibiotics12071152.
Tetracycline-class drugs are frequently used in dermatology for their anti-inflammatory properties to treat skin diseases such as acne, rosacea, and hidradenitis suppurativa (HS). The American Academy of Dermatology (AAD) clinical guidelines do not offer guidance regarding the co-administration of food with tetracycline-class drugs. The objectives of this study were to review the available evidence regarding whether taking tetracycline-class drugs with food decreases systemic absorption and is associated with an impact on clinical efficacy. A literature search was conducted using the PubMed database between February to May 2023 using the keywords "tetracycline-class drugs", "pharmacokinetics", "absorption", and "dermatology". Inclusion criteria included articles written in English and relevant to the absorption and efficacy of tetracycline-class drugs. This search yielded 131 articles written between 1977 to 2022, of which 29 met the criteria for review. United States Food and Drug Administration (FDA)-approved prescribing information for oral formulations of tetracycline, doxycycline, minocycline, and sarecycline were reviewed. Systemic absorption of tetracycline decreased when co-administered with food. Systemic absorption of oral doxycycline and minocycline was variable with food co-administration. The impact on bioavailability varied with the drug formulation and dosage. The absorption of oral sarecycline decreased when administered with food. Sarecycline is the only oral antibiotic where population pharmacokinetic studies demonstrated limited or no impact of food intake on clinical efficacy. There are no available data for other tetracycline-class drugs in dermatology. If patients find it more tolerable to take doxycycline, minocycline, and sarecycline with food to avoid gastrointestinal distress, this may merit consideration to encourage patient adherence. Since the impact of food intake on absorption varied with the dosage form of doxycycline and minocycline, consulting the appropriate package insert may give clinicians additional insight into differences in the various formulations.
四环素类药物因其抗炎特性，常用于皮肤科治疗痤疮、玫瑰痤疮和化脓性汗腺炎（HS）等皮肤病。美国皮肤科协会（AAD）的临床指南未就四环素类药物与食物同时服用提供指导。本研究的目的是回顾现有证据，探讨四环素类药物与食物同服是否会降低全身吸收以及是否会影响临床疗效。2023年2月至5月期间，使用关键词“四环素类药物”“药代动力学”“吸收”和“皮肤科”在PubMed数据库中进行了文献检索。纳入标准包括用英文撰写且与四环素类药物吸收和疗效相关的文章。此次检索共得到1977年至2022年间撰写的131篇文章，其中29篇符合综述标准。对美国食品药品监督管理局（FDA）批准的四环素、多西环素、米诺环素和沙瑞环素口服制剂的处方信息进行了审查。四环素与食物同时服用时，全身吸收会降低。口服多西环素和米诺环素的全身吸收随食物同服情况而变化。对生物利用度的影响因药物剂型和剂量而异。沙瑞环素口服给药时与食物同服，其吸收会降低。沙瑞环素是唯一一种群体药代动力学研究表明食物摄入对临床疗效影响有限或无影响的口服抗生素。皮肤科中其他四环素类药物尚无可用数据。如果患者发现与食物同服多西环素、米诺环素和沙瑞环素更易耐受，可避免胃肠道不适，那么这可能值得考虑，以鼓励患者坚持用药。由于食物摄入对多西环素和米诺环素吸收的影响因剂型而异，查阅相应的药品说明书可能会让临床医生进一步了解不同制剂之间的差异。
