Achromycin

Generic Name: Tetracycline hydrochloride
Product Name: Achromycin

Indication

Achromycin is used for the treatment of infections caused by the following:

Gram negative micro-organisms:

Haemophilus ducreyi (chancroid)
Pasteurella pestis & tularensis
Bartonella bacilliformis
Bacteroides sp
Vibrio comma & fetus

Brucella sp. Miscellaneous micro-organisms:

Richettsiae (Rocky Mountain spotted fever, typhus fever and the typhus group, Q fever, rickettsial pox, tick fever),
Mycoplasma pneumoniae
agents of psittacosis
agents of lymphogranuloma venereum and granuloma inguinale
Borrelia recurrentis.

Tetracycline may also be used for the treatment of the following infections provided laboratory testing indicates appropriate sensitivities:

Gram negative mico-organisms:

Escherichia coli
Haemophilus influenzea
Klebsiella sp
Enterobacter aerogenes
Shigella sp
Mimi sp
Herallea sp

Gram positive micro-organisms: Streptococcus sp, Staphlycoccus aureus. When penicillin is contraindicated, tetracyclines are alternative antibiotic agents for infections due to:

Treponema pallidum & pertenue (syphilis & yaws)
Listeria monocytogenes
Clostridium sp
Bacillus anthracis.

Tetracyclines may be used as adjunctive therapy for severe acne. Oral and topical tetracyclines may be used to treat inclusion conjunctivitis.

Action

Tetracylcine is bacteriostatic. It is thought to exert its effect through protein synthesis inhibition.

A variety of gram positive and negative bacteria are susceptible to tetracyclines. The drugs in the tetracycline class have similar antimicrobial spectra, and resistance to one tetracycline is likely to extend to other drugs in the class. Tetracycline is rapidly though incompletely absorbed from the gut. Food, milk, antacids and cations (divalent & trivalent) impair absorption. Most of the absorbed dose is eliminated unchanged in urine and bile, any additional absorbed drug is metabolised in the liver. Protein binding ranges between 24-65% Peak serum levels after a single 250 mg dose are achieved in 2-4 hours.

Dose advice

Streptococcal infections

Adults: 1-2 g per day, in 4 equally divided doses.

Children >8yrs: 25-50 mg/kg, in 4 equally divided doses.

Brucellosis

500 mg, four times daily, for three weeks. Accompanied by streptomycin: 1 g intramuscularly twice daily the first week, and once daily for the second week.

Syphilis

30-40 g in equally divided doses, over a period of 10-15 days.

Impaired renal function

Dose should be decreased by reduction of actual dose and frequency between doses.

Schedule

Schedule 4

Common side effects

Anorexia
Nausea
Vomiting
Diarrhoea
Dysphagia
Enterocolitis
Rashes
Photosensitivity
Superinfection: antibiotic use may be associated with overgrowth of non-susceptible organisms (e.g. fungi). In the event of superinfection, the antibiotic should be ceased and appropriate therapy started.