Doxycycline Prophylaxis for Leptospirosis

Recommended Dosing Regimen

The Centers for Disease Control and Prevention recommends initiating doxycycline 200 mg orally one week before exposure and continuing 200 mg orally once weekly during exposure, with a final 200 mg dose at completion of exposure, for high-risk, time-limited exposures 1
The Centers for Disease Control and Prevention suggests continuing 200 mg orally once weekly during exposure for high-risk, time-limited exposures 2

The Centers for Disease Control and Prevention advises that doxycycline should be used with extreme caution in pregnant women and only when the risk of leptospirosis clearly outweighs the risks of tetracycline exposure to the fetus 2
The Centers for Disease Control and Prevention recommends that for children weighing <45 kg, use 2.2 mg/kg every 12 hours if daily dosing is required; for children ≥45 kg, use adult dosing of 100 mg every 12 hours for treatment 3

The Centers for Disease Control and Prevention notes that to minimize photosensitivity reactions and gastrointestinal side effects, do not exceed 200 mg in any 24-hour period 1