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August 15, 1977

Prescribing of Tetracycline to Children

Author Affiliations

University of North Carolina North Carolina Memorial Hospital Chapel Hill

JAMA. 1977;238(7):579. doi:10.1001/jama.1977.03280070019003

To the Editor.—  While I cannot condone the use of tetracycline for the treatment of common respiratory disease or nonspecific disorders in children, the apparent total condemnation of the drug by Ray, Federspiel, and Schaffner (237:2069, 1977) is a bit strong.Rickettsial disease, for example, represents one important use for tetracyclines in children. In the southeast, where Rocky Mountain spotted fever is prevalent, many pediatricians might prefer to treat the disease with tetracycline rather than risk the bone marrow depression and aplastic anemia associated with chloramphenicol therapy. Tetracycline is also the drug of choice in infections caused by chlamydia and the more exotic organisms Brucella, Borrelia, and Vibrio.Finally, Ray and associates have overemphasized the risk of prescribing limited amounts of tetracycline to adolescents. Careful studies have shown that the amount of dental staining caused by tetracycline is related to the total administered dose, the number of courses given, and