Orr L H, Rudisill E, Brodkin R, Hamilton R W
Arch Intern Med. 1978 May;138(5):793-4.
Doxycycline has been considered a safe broad-spectrum antibiotic for patients with renal failure. Although doxycycline possesses many of the metabolic properties of the tetracycline group, toxic blood levels usually do not occur because of the drug's unique extrarenal route of excretion. We report here a patient with stable chronic renal failure whose renal function acutely and reversibly deteriorated coincident with a 14-day course of doxycycline. Review of the literature suggests that occasional patients may have impairment of the nonrenal excretory pathway for doxycycline. We speculate that these patients are at risk for developing nephrotoxic levels of this antibiotic.
多西环素一直被认为是肾衰竭患者安全的广谱抗生素。尽管多西环素具有四环素类药物的许多代谢特性，但由于其独特的肾外排泄途径，通常不会出现药物毒性血药浓度。我们在此报告一名慢性肾衰竭稳定患者，其肾功能在接受14天多西环素治疗期间急性且可逆性恶化。文献回顾表明，偶尔有患者可能存在多西环素肾外排泄途径受损的情况。我们推测这些患者有发生该抗生素肾毒性血药浓度的风险。
