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I read with interest the response by Dr Tice¹ to Drs Joshi and Miller's² article recently published in the ARCHIVES entitled "Doxycycline Revisited." Tice mentioned that doxycycline may be administered on a once-daily basis owing to its long serum half-life, and Dr Tice correctly pointed out a loading dose of doxycycline should be administered to achieve more rapid blood levels.

It is true that because of its lipid solubility characteristics and long serum half-life, optimally doxycycline should initially be administered as a high dose (200 mg intravenously [IV] or orally every 12 hours) to saturate the serum and tissue compartments for 72 hours before completing the course of therapy with the conventional dose of, 100 mg IV or orally every 12 hours. Tice suggests a "loading dose" of doxycycline at the start of therapy. However, although a single loading dose is sufficient with many other antibiotics, eg, aminoglycosides, multiple doses . . . [Full Text of this Article]

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