Joshi and Miller1 are to be applauded for their revisitation of doxycycline, an off-patent and therefore undermarketed and underused antibiotic. Three comments seem worthwhile.
First, doxycycline is noted to be the drug of choice for treating nongonococcal urethritis (usually from Chlamydia trachomatis) and cervicitis in women. The pharmacy cost of a course (7 days) of the drug is much less than that of the primary alternative, azithromycin (a single dose). However, patient acceptability and compliance are better with azithromycin, and the total cost of treatment with azithromycin may be identical to or lower than that of doxycycline (failed therapy from noncompliance with doxycycline can prompt additional costly clinic visits).2,3 Therefore, many clinics now use azithromycin as their agent of choice (in addition to antigonococcal therapy) for the treatment of nongonococcal urethritis and cervicitis.
Revisiting Doxycycline. Arch Intern Med. 1998;158(13):1469-1472. doi: