Antimalarial Prophylaxis with Doxycycline

Indications and Usage

The Centers for Disease Control and Prevention recommends doxycycline as an alternative regimen for travelers to areas with chloroquine-resistant Plasmodium falciparum 1
Doxycycline is a first-line option for areas with mefloquine-resistant falciparum malaria, particularly in East Asia, according to the British Medical Journal 2, 3
The CDC suggests doxycycline is appropriate for short-term travelers who cannot tolerate mefloquine or for whom mefloquine is contraindicated 1

Photosensitization may occur but is uncommon with doxycycline use; excessive exposure to sun should be avoided, as reported in the British Medical Journal 2, 3
Doxycycline is not recommended for children under 8 years of age, pregnant women, or lactating mothers, according to the British Medical Journal 2
Drug interactions, such as with phenytoin, carbamazepine, and barbiturates, may shorten the half-life of doxycycline, as noted in the British Medical Journal 4

Compliance is essential for effective prophylaxis; most malaria deaths occur in travelers who do not fully comply with prophylaxis regimens, as reported in the British Medical Journal 2, 4

The Centers for Disease Control and Prevention recommends using insect repellents containing DEET on exposed skin 6
Wearing long-sleeved clothing and long trousers if outdoors after sunset is advised, according to the British Medical Journal 3
Using pyrethrum-containing flying-insect spray in living and sleeping areas is recommended by the Centers for Disease Control and Prevention 6
Considering permethrin-treated clothing and mosquito nets for additional protection is suggested by the Centers for Disease Control and Prevention and the British Medical Journal 6, 3