The frequency of permanent staining of teeth of young children from doxycycline is thought to be lower than from older tetracyclines, but the precise risk is uncertain. Until more definitive data become available, doxycycline should not be used routinely to treat young children with erythema migrans, a manifestation of Lyme disease for which other antimicrobials are highly effective.
From the *Division of Infectious Diseases, New York Medical College, Valhalla, New York
†Department of Infectious Diseases, University Medical Center Ljubljana, Slovenia
‡Departments of Pediatrics and of Epidemiology of Microbial Diseases, Yale University, New Haven, Connecticut.
Accepted for publication July 17, 2019.
This publication was made possible, in part, by CTSA Grant Number UL1 TR000142 from the National Center for Advancing Translational Science (NCATS) at the National Institutes of Health and NIH Roadmap for Medical Research (EDS). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NIH.
Dr. Wormser reports receiving research grants from Immunetics, Inc., Institute for Systems Biology, Rarecyte, Inc. and Quidel Corporation. He owns equity in Abbott/AbbVie; has been an expert witness in malpractice cases involving Lyme disease; and is an unpaid board member of the American Lyme Disease Foundation. Dr. Shapiro has received royalty payments from UpToDate; has been an expert witness in malpractice cases involving Lyme disease and is an unpaid board member of the American Lyme Disease Foundation. Dr. Franc Strle served on the scientific advisory board for Roche on Lyme disease serologic diagnostics, and is an unpaid member of the steering committee of the ESCMID Study Group on Lyme Borreliosis/ESGBOR.
Address for correspondence: Gary P. Wormser, MD, Division of Infectious Diseases, New York Medical College, 40 Sunshine Cottage Road, Skyline Office #2N-F05, Valhalla, NY 10595. E-mail: email@example.com.