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Long-term tetracycline use in the treatment of acne vulgaris--the role of routine laboratory monitoring.

Abstract The medical directors of 125 college health services were surveyed to determine the frequency and extent of routine laboratory monitoring of patients with acne treated with low-dose oral tetracycline. Thirty-seven percent of the practitioners in 89 health services treating acne routinely order screening tests. Thirty-five percent obtain blood counts, 24% obtain liver function tests, and 21% order both types of tests. Sixty-three percent of health service practitioners ordered no routine laboratory testing. A literature review revealed that the reported renal, hepatic, and hematopoietic side effects of tetracycline occurred in patients on high-dose intravenous therapy, in critically ill or hospitalized patients, in patients with initial renal insufficiency, or in older patients. Although idiosyncratiac reactions have occurred, no significant side effects found by routine monitoring have been reported with low-dose oral tetracycline in healthy patients. A more cost-effective approach to the use of ...