Doxycycline and Tooth Discoloration in Children: Changing of Recommendations Based on Evidence of Safety

Doxycycline use has historically been limited to children older than 8 years because of concerns regarding permanent tooth discoloration. Six studies assessed tooth discoloration in at least 338 patients exposed to doxycycline before 8 years of age. Six patients had potential discoloration, but studies consistently found no difference in tooth discoloration between exposed patients and controls. Recommendations have changed stating doxycycline, but not other tetracyclines, can be used for short courses (<21 days) regardless of age. Clinicians should be aware of these data because doxycycline use may extend to disease states apart from tick-borne illnesses in pediatric patients.