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테트라사이클린

Tetracycline

Tetracycline hydrochloride

테트라사이클린계 항생제POIVIMIntrapleural (pleurodesis)개고양이소형 포유류페렛새말소돼지양

다른 이름: Aquadrops · Panmycin · Sumycin · Polyotic · Delta Albaplex · Tetracycline HCl · tetracyclini hydrochloridum

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

감사 완료 v13 용량 근거

구조화 용량 계산 근거

Susceptible infections (extra-label)

25 mg/kgPO
  • q8-12h

NA

반드시 함께 고려할 임상 맥락 (2)
  • ■ This medicine is best given without food. Avoid giving this medicine orally within 1 to 2 hours of milk or other dairy products.
  • Unless otherwise instructed by the manufacturer, tetracycline oral tablets and capsules should be stored in tight, light-resistant containers at room temperature (15°C-30°C [59°F-86°F]).
formulary프로토콜 2023감사 dose-audit-plumb-v13

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개요

테트라사이클린은 원형의 단기 작용 ​테트라사이클린계 항생제​입니다. 역사적으로 광범위 항균제로 사용되었으나, 세균 내성 증가로 인해 임상적 역할이 변화하였습니다.

현대 수의학에서:

  • ​소동물 임상​: 감염성 질환의 경우 조직 침투력이 좋고 투여 빈도가 낮은 독시사이클린이 일반적으로 선호됩니다. 그러나 테트라사이클린은 ​나이아신아마이드​와 병용하여 면역 매개성 피부 질환(예: 원판상 홍반성 루푸스, 천포창)을 치료하기 위한 면역 조절 목적으로 자주 사용됩니다.
  • ​대동물 임상​: 일반적으로 옥시테트라사이클린이 선호됩니다.

​임상 요점​:

  • 마이코플라스마​, ​리케차​, 스피로헤타(예: 라임병), ​클라미디아와 같은 비정형 병원체에 여전히 효과적입니다.
  • 상당한 ​항염증 및 면역 조절 특성​을 지니고 있어 수의 피부과에서 가치가 높습니다.

작용 기전

Tetracycline is a time-dependent, bacteriostatic antibiotic.

  • Antimicrobial Action: Reversibly binds to the 30S ribosomal subunit of susceptible organisms → prevents binding of aminoacyl transfer-RNA to the ribosome → inhibits bacterial protein synthesis. It may also bind to the 50S subunit and alter cytoplasmic membrane permeability.
  • Immunomodulatory/Anti-inflammatory Action: Suppresses antibody production and neutrophil chemotaxis. Inhibits key inflammatory mediators including lipases, collagenases, prostaglandin synthesis, and the activation of complement component 3.

안전성·주의사항

금기사항

  • Hypersensitivity to tetracyclines
  • Pregnancy (last half) - retards fetal skeletal development and discolors teeth
  • Young, growing animals (unless benefits outweigh risks)

부작용

  • Gastrointestinal distress (nausea, vomiting, anorexia, diarrhea)
  • Discoloration of developing teeth and bones (yellow/brown/gray)
  • Delayed bone growth and healing in young animals
  • Superinfections (bacterial or fungal overgrowth)
  • Photosensitivity
  • Urolith formation (with long-term use in dogs)
  • Hepatotoxicity and blood dyscrasias (rare)
  • Cats: Colic, fever, hair loss, depression (poorly tolerated)
  • Horses: Severe diarrhea (especially if stressed)
  • Ruminants: Ruminal microflora depression and stasis (high oral doses)
  • Injection site reactions (IM): Local necrosis and yellow staining

주의

Extreme Caution: Pregnancy (Category D). Can cause congenital malformations, embryotoxicity, and discoloration of deciduous teeth.

  • Renal/Hepatic Impairment: Use cautiously. Lower dosages and enhanced monitoring are recommended. Avoid concurrent nephrotoxic or hepatotoxic drugs.
  • Cats: Do not tolerate oral tetracycline well; monitor closely for adverse effects.
  • IV Administration: Rapid IV injection can cause transient collapse and cardiac arrhythmias due to calcium chelation. Administer slowly or pre-treat with IV calcium gluconate if rapid injection is necessary.

약물 상호작용

Atovaquone

Tetracyclines may decrease atovaquone levels.

Beta-lactam or Aminoglycoside Antibiotics

Theoretical antagonism of bactericidal activity, though clinical significance is doubtful.

Digoxin

May increase bioavailability of digoxin, potentially causing toxicity that persists for months.

Divalent or Trivalent Cations (Antacids, Calcium, Iron, Magnesium, Zinc, Bismuth)

Chelation occurs, significantly decreasing the absorption of tetracycline. Separate doses by at least 1-2 hours.

Methoxyflurane

Concomitant use can cause fatal nephrotoxicity.

Sucralfate

May impair oral absorption of tetracycline; separate dosing by at least 2 hours.

Warfarin

May depress plasma prothrombin activity; anticoagulant dosage adjustment may be needed.

모니터링

  • Adverse effects (GI signs, injection site reactions)
  • Clinical efficacy
  • Periodic renal, hepatic, and hematologic evaluations (with long-term use or in susceptible patients)

약동학

반감기

고양이5-6 hours개5-6 hours

흡수

Readily absorbed after oral administration in fasting animals (bioavailability ~60-80%). Food or dairy products can significantly reduce absorption by 50% or more. Erratically and poorly absorbed after IM administration.

분포

Widely distributed to heart, kidney, lungs, muscle, pleural fluid, bronchial secretions, bile, saliva, urine, synovial fluid, and aqueous/vitreous humor. Poor penetration into CSF. Crosses the placenta and distributes into milk. Volume of distribution is ~1.2-1.3 L/kg in small animals and 1-2.5 L/kg in cattle.

대사

Apparently not metabolized.

배설

Eliminated unchanged primarily via glomerular filtration. Excreted into the GI tract via biliary and nonbiliary routes (may become inactive after chelation with fecal materials). Patients with impaired renal function can accumulate the drug.

과다투여

Tetracyclines are generally well tolerated after acute overdoses.

  • Oral Overdose: Most likely associated with GI disturbances (vomiting, anorexia, diarrhea). Monitor fluids and electrolytes if severe emesis/diarrhea occurs.
  • Chronic Overdose: May lead to drug accumulation and nephrotoxicity.
  • Ruminants: High oral doses can cause ruminal microflora depression and ruminoreticular stasis.
  • IV Overdose/Rapid Injection: Rapid IV injection can induce transient collapse and cardiac arrhythmias, presumably due to chelation with intravascular calcium ions. If rapid IV administration is necessary, pre-treatment with intravenous calcium gluconate is recommended by some clinicians.

제품

제형

  • Capsules
  • Oral Suspension
  • Soluble Powder (water additive)
  • Injection (rarely used in small animals)

동물용의약품

  • Tetracycline HCl Soluble Powder (water additive): 25 grams/lb or 324 grams/lb
  • Delta Albaplex (Combination product containing tetracycline, novobiocin, and prednisone)

인용의약품

  • Tetracycline HCl Capsules: 250 mg & 500 mg (Sumycin, generic)
  • Tetracycline HCl Oral Suspension: 25 mg/mL (Sumycin Syrup)

규제 현황

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보관·안정성

Store oral tablets and capsules in tight, light-resistant containers at room temperature (15-30°C). Store oral suspension and powder for injection at room temperature; avoid freezing the oral suspension.

보호자 정보

  • ​투여 방법​: 가능하면 이 약을 공복에 투여하십시오. 약물의 흡수를 크게 감소시킬 수 있으므로, 식사나 우유/유제품을 먹이기 전후 1~2시간 이내에는 투여를 피하십시오.
  • ​위장 장애​: 반려동물이 구토를 하거나 메스꺼워하는 경우, 소량의 비유제품 음식과 함께 약을 투여하면 도움이 될 수 있습니다. 단, 약효가 약간 감소할 수 있습니다.
  • ​햇빛​: 이 약은 반려동물의 피부를 햇빛에 더 민감하게 만들 수 있습니다(광과민성). 장시간의 햇빛 노출을 피하십시오.
  • ​변색​: 성장 중인 어린 동물의 경우, 이 약이 치아를 영구적으로 노랗거나 갈색으로 변색시킬 수 있으므로 주의하십시오.

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