Oxytetracycline
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Medically reviewed by
Mr Craig Marsh
Independent Prescriber
on May 14, 2024.
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What does oxytetracycline treat?

Oxytetracycline is active against a broad range of bacteria and can be used to treat pneumonia, infections of the urinary tract, skin and soft tissues (like muscles, nerves, fat, blood vessels, tendons and ligaments). It’s also effective in treating flare-ups of bronchitis, especially those caused by the bacteria Haemophilus influenzae.

It’s can also be used for less common infections, including those caused by a group of microorganisms called rickettsiae, like Rocky Mountain spotted fever—a disease transmitted through the bite of an infected tick.

But oxytetracycline is mainly used to treat acne because it’s effective against the bacterium that causes breakouts, called Propionibacterium acnes (or Cutibacterium acnes). This common bacteria thrives on the skin’s sebum, creating waste products that irritate sebaceous glands (tiny glands in your hair follicles that secrete sebum), causing inflammation and spots.

How does it work?

Oxytetracycline targets the bacterium Propionibacterium acnes, responsible for acne breakouts. It disrupts the bacteria's ability to produce vital proteins. Without these proteins, the bacteria can't grow or multiply. This halts the infection, and your immune system takes care of the remaining bacteria, causing them to eventually die.

Oxytetracycline belongs to the antibiotic family of tetracyclines and like most other drugs in this class, it also works by calming inflammation and aiding the skin's healing process. This is essential because the bacteria that causes acne, Propionibacterium acnes, tends to trigger inflammation, contributing to acne lesions (spots).

What branded treatments use oxytetracycline?

Oxytetracycline is not available as a standalone branded treatment in the UK, but two branded topical treatments use oxytetracycline in combination with other active ingredients: Trimovate cream and Terra-cortil ointment.

Trimovate contains oxytetracycline calcium, clobetasone butyrate (an anti-inflammatory medication) and nystatin (used for fungal infections like candidosis). It’s prescribed for various skin conditions, including atopic dermatitis, nappy rash, and seborrhoeic dermatitis.

The second treatment, Terra-cortil, is an ointment containing oxytetracycline hydrochloride and hydrocortisone (an anti-inflammatory medication). It’s recommended for skin conditions like atopic eczema, allergic and seborrhoeic dermatitis, and infected insect bite reactions.

Can you get generic oxytetracycline?

Yes, generic oxytetracycline is available from different manufacturers as Oxytetracycline 250mg tablets. These tablets are typically yellow, round, sugar-coated, and contain the active ingredient as oxytetracycline dihydrate.

Is oxytetracycline only available on prescription?

Oxytetracycline, being an antibiotic, falls under the category of prescription-only medications. This is because the use of antibiotics requires close monitoring by a doctor or pharmacist, as bacteria are building resistance to some antibiotics. So it's important to use them wisely and only under expert supervision.

What doses of oxytetracycline are available?

Oxytetracycline is available in different doses depending on the formulation. The coated tablets come in a dose of 250mg (as oxytetracycline dihydrate). On the other hand, both topical formulations, Trimovate cream and Terra-cortril ointment, contain 30mg of oxytetracycline as oxytetracycline calcium.

How do you take it?

You should take the oxytetracycline tablets on an empty stomach, either an hour before or two hours after meals. This ensures the medicine gets absorbed properly, as food and dairy can reduce its absorption, making the treatment less effective. Also, you should avoid indigestion medications containing calcium, aluminium, iron, zinc or magnesium two hours before or after your tablets. They can also affect how much of the medicine is absorbed by your body.

When taking the tablets, swallow them with plenty of water while sitting or standing to prevent any throat irritation.

For acne and rosacea, you’ll typically be advised to take 500mg (two tablets) twice a day—once in the morning and once in the evening. For rosacea, the treatment duration is six to 12 weeks, while acne treatment typically lasts for up to three months or until your clinician advises you to stop.

For other bacterial infections, the dosage and treatment length will vary based on the type and severity of the infection. But you’ll likely be advised to take one or two tablets four times a day, with doses spaced every six hours.

Does oxytetracycline work?

In short, yes. This is why oxytetracycline is often prescribed for treating acne, especially in mild to moderate cases. But let’s look at its effectiveness in numbers.

In a clinical trial, 131 participants dealing with mild to moderate inflammatory acne on the face took 500mg of oral oxytetracycline twice daily. By the 18th week, 55% of those treated with oxytetracycline reported moderate or greater improvement, with most progress seen in the first six weeks.

The effectiveness of a daily treatment with oxytetracycline (750mg) was also tested in another small study involving 28 people with acne. After four weeks of treatment, the severity of acne decreased to around 55% of the initial values. This improvement continued over 12 weeks, leading to a reduction in the total number of lesions (spots) to 28–39% of the initial values. So, although these studies didn’t involve huge numbers of people, they give an indication of the effectiveness of oxytetracycline.

What are the benefits of oxytetracycline?

Oxytetracycline acts on the root cause of acne, the bacterial infection that’s responsible for its symptoms, and prevents the bacteria from growing further. It also reduces inflammation and helps prevent scarring associated with acne. So it could be seen as a 2-in-1 treatment for acne, which can make it more appealing.

Another benefit is that treatment with oxytetracycline is generally safe and has minimal side effects. And it’s also cost-efficient. For example, oxytetracycline’s effectiveness is similar to minocycline, another common acne treatment, but at about one-seventh of the cost.

How soon should you notice oxytetracycline work?

With acne treatments, it’s important not to expect results overnight. It takes time for the treatments to work, often weeks or months. If you’re taking oral antibiotics like oxytetracycline, you’ll typically notice improvements within the first four to eight weeks of acne treatment.

It’s also important to complete the full course of oxytetracycline as prescribed, even if the symptoms improve or the infection seems to clear. Ending the treatment early increases the chance of the infection coming back and bacteria becoming resistant to the antibiotic. At the same time, it’s important to stop the antibiotic treatment after three months, unless your clinician advises otherwise, to prevent antibiotic resistance.

Is oxytetracycline safe?

Yes, it’s generally safe to use. Studies indicate that oxytetracycline can effectively reduce acne severity and improve lesions within 12 weeks of treatment without definite side effects.

It may not be safe for you to take oxytetracycline tablets if you:

  • have an allergy to tetracyclines or any of the tablet’s ingredients. This is more common if you’re allergic to aspirin;
  • have a severe liver or kidney issue;
  • have porphyria (a rare genetic disorder where proteins called porphyrins build up in your body, leading to symptoms like abdominal pain, skin sensitivity to sunlight and seizures);
  • are pregnant or breastfeeding (oxytetracycline may pass into the milk and cause staining of the infant’s teeth);
  • have lupus; or:
  • take vitamin A or retinoid therapy.

Oxytetracycline is also not suitable for children under 12 years old.

What side effects are linked to oxytetracycline?

Side effects of oxytetracycline are mostly related to the gastrointestinal system and can include nausea, diarrhoea, stomach ache, and loss of appetite. If the medicine upsets your stomach, it’s recommended to take it with food.

Other potential side effects involve skin reactions like rash, itching, or increased sensitivity to sunlight. Candidiasis (thrush) is also possible after treatment with broad-spectrum antibiotics. If you experience this, you should ask your clinician for advice on what to do next.

Other rare but serious risks associated with oxytetracycline include the potential harm to calcium-rich organs like teeth and bones. Due to these potential risks, oxytetracycline is generally not recommended for pregnant or breastfeeding women and children under 12. But sometimes exceptions may be made by a specialist where there are no suitable alternatives available.

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This page was medically reviewed by Mr Craig Marsh, Independent Prescriber on May 14, 2024. Next review due on May 14, 2026.

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