Doxycycline has been the first line medication for malaria prevention in the ADF since 1990. It is an antibiotic that is widely used in Australia to treat a variety of infections (respiratory, skin) and is effective in preventing malaria. Because of its antibiotic properties, it also provides protection against other infections that soldiers may be exposed to on deployment, such as leptospirosis and scrub typhus.
When used for malaria prophylaxis doxycycline needs to be taken every day starting at least two days before entering a malarious area and continuing for two weeks after leaving the area. Because it is a daily dose, compliance can be a problem and cases of malaria have occurred in people who have not taken this tablet every day.
Generally doxycycline is very well tolerated; however as with all drugs it does have side effects. Doxycycline commonly causes gastrointestinal (gut) upset, such as heartburn and vomiting, which can be minimised by taking the medication with food. It can also cause photosensitivity (an increased risk of sunburn), which can be minimised by the liberal use of sun protection, including sunscreen. Doxycycline is not suitable for pregnant women or young children as it can affect developing teeth. Rarely, it has been associated with psychiatric symptoms, such as depression and anxiety. Some people cannot tolerate doxycycline and need to be prescribed a different anti-malarial before entering a malarious area.
Consumer medicine information about doxycycline (Doxylin) is available at https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2010-CMI-04553-3
Product information for prescribers is also available at https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2010-PI-04552-3.