Doxycycline Dosing Guidelines for Various Conditions

Condition-Specific Dosing

The Infectious Diseases Society of America recommends a single dose of 200 mg for adults and 4 mg/kg (maximum 200 mg) for children ≥8 years after high-risk tick bite for Lyme Disease Prophylaxis 1, 2
For Early Lyme Disease, the recommended dose is 100 mg twice daily for 10-21 days (adults); 4 mg/kg/day in 2 divided doses for children ≥8 years (maximum 100 mg per dose) 1, 3
The Centers for Disease Control and Prevention recommends 100 mg twice daily for 10 days (adults); 4 mg/kg/day in 2 divided doses for children (maximum 100 mg per dose) for Human Granulocytic Anaplasmosis (HGA) 4, 5
For Doxycycline PEP for STI Prevention, the Centers for Disease Control and Prevention recommends 200 mg as a single dose within 72 hours after sexual exposure (not to exceed 200 mg per 24 hours) 6, 7

The American College of Obstetricians and Gynecologists and the Centers for Disease Control and Prevention advise that doxycycline is generally contraindicated during pregnancy; alternative agents should be considered 4, 8
The Centers for Disease Control and Prevention recommends that children <8 years should not be given doxycycline due to potential for dental staining; however, it may be used for severe infections when benefits outweigh risks 8
The Centers for Disease Control and Prevention advises patients to avoid sun exposure due to increased risk of photosensitivity reactions 2

The Infectious Diseases Society of America recommends 100 mg twice daily orally for Methicillin-Susceptible S. aureus (MSSA) and Methicillin-Resistant S. aureus (MRSA) 9

The Centers for Disease Control and Prevention recommends 100 mg twice daily for 14 days (adults); 2.2 mg/kg per dose twice daily for children ≥8 years (maximum 100 mg per dose) for Q Fever (acute) 8
For Q Fever (chronic), the recommended dose is 100 mg twice daily plus hydroxychloroquine 200 mg three times daily for ≥18 months 8

The American Academy of Clinical Infectious Diseases recommends a single 200mg dose of doxycycline for post-exposure prophylaxis for Lyme disease after high-risk tick bites in adults 10
The Hepatology society defines a "stable HBV carrier" as having inactive disease with normal or minimally elevated liver enzymes, low HBV DNA, and no active hepatic inflammation, and notes that inactive HBV carriers do not require antiviral treatment and have preserved hepatic function 11

The Hepatology society guidelines imply that stable HBV carriers with normal liver enzymes, HBV DNA <2000 IU/mL, and no evidence of cirrhosis can safely receive a single 200mg dose of doxycycline 11