Doxycycline is an oral and intravenous bacteriostatic tetracycline antibiotic which binds to the 30S bacterial ribosomal subunit rendering protein synthesis ineffective. This class of antibiotics has a broad range encompassing some coverage for MRSA, gram negatives, and atypical organisms. Among these are early Lyme disease, vibrio, brucellosis, Q fever, anthrax, rickettsia, malaria prophylaxis, Rocky Mountain Spotted Fever, etc. The drug has excellent bioavailability as well.

In addition to the “vanc-cefepime” and “azithro-ceftriaxone” antibiotic combinations to cover for bacterial superinfections in COVID-19, I’ve also used ceftriaxone with doxycycline. One of the most appealing aspects of doxycycline is that it doesn’t require renal dose adjustment as most of it is eliminated in the intestinal tract.

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