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Chlortetracycline
View on Wikipediafrom Wikipedia
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| Clinical data | |
|---|---|
| Trade names | Aureomycin |
| AHFS/Drugs.com | Micromedex Detailed Consumer Information |
| Routes of administration | By mouth, IV, topical |
| ATC code | |
| Pharmacokinetic data | |
| Bioavailability | 30% |
| Protein binding | 50 to 55% |
| Metabolism | Gastrointestinal tract, hepatic (75%) |
| Metabolites | Isochlortetracycline |
| Elimination half-life | 5.6 to 9 hours |
| Excretion | 60% renal and >10% biliary |
| Identifiers | |
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| CAS Number | |
| PubChem CID | |
| DrugBank | |
| ChemSpider | |
| UNII | |
| KEGG | |
| ChEMBL | |
| E number | E702 (antibiotics) |
| CompTox Dashboard (EPA) | |
| ECHA InfoCard | 100.000.310 |
| Chemical and physical data | |
| Formula | C22H23ClN2O8 |
| Molar mass | 478.88 g·mol−1 |
| 3D model (JSmol) | |
| Specific rotation | [α]D25−275°·cm3·dm−1·g−1 (methane) |
| Melting point | 168 to 169 °C (334 to 336 °F) |
| Solubility in water | 0.5–0.6 mg/mL (20 °C) |
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Chlortetracycline (trade name Aureomycin, Lederle Laboratories) is a tetracycline antibiotic, the first tetracycline to be identified. It was discovered in 1945 at Lederle Laboratories under the supervision of Yellapragada Subbarow and Benjamin Minge Duggar. They were helped by Louis T. Wright,[2] a surgeon who conducted this medication's first human experiments. Duggar identified the antibiotic as the product of an actinomycete he cultured from the soil of Sanborn Field at the University of Missouri.[3] The organism was named Streptomyces aureofaciens and the isolated drug, Aureomycin, because of their golden color.[1]
It is on the World Health Organization's List of Essential Medicines.[4]
Medical uses
[edit]A combination cream with triamcinolone acetonide is available for the treatment of infected allergic dermatitis in humans.[5]
In veterinary medicine, chlortetracycline is commonly used to treat conjunctivitis in cats,[6] dogs and horses. It is also used to treat infected wounds in cattle, sheep and pigs, and respiratory tract infections in calves, pigs and chickens.[5]
Contraindications
[edit]Chlortetracycline for systemic use is contraindicated in animals with severe hepatic or renal impairment. Topical chlortetracycline must not be used on the udder of animals whose milk is intended for human consumption.[5]
Adverse effects
[edit]Like other tetracyclines, chlortetracyclin can inhibit bone and tooth mineralization in growing and unborn animals, and color their teeth yellow or brown. It can also impair liver and kidney function. Allergic reactions are rare.[5]
Interactions
[edit]Chlortetracycline may increase the anticoagulant activities of acenocoumarol. The risk or severity of adverse effects can be increased when chlortetracycline is combined with acitretin, adapalene, or alitretinoin. Aluminum phosphate and aluminum hydroxide can cause decreases in the absorption of chlortetracycline resulting in a reduced serum concentration and potentially a decrease in efficacy. The therapeutic efficacy of mecillinam (amdinocillin), amoxicillin, and ampicillin can be decreased when used in combination with chlortetracycline. Chlortetracycline may increase the neuromuscular blocking activities of atracurium besilate.[7]
Pharmacology
[edit]Mechanism of action
[edit]References
[edit]- ^ a b "chlortetracycline | C22H23ClN2O8 - PubChem". Pubchem.ncbi.nlm.nih.gov. Retrieved 2017-03-13.
- ^ Posner, Gerald. PHARMA : Greed, Lies, and the Poisoning of America. S.L., Avid Reader Pr, 2021, pp. 47–57.
- ^ Jukes TH (1985). "Some historical notes on chlortetracycline". Reviews of Infectious Diseases. 7 (5): 702–7. doi:10.1093/clinids/7.5.702. PMID 3903946.
- ^ World Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.
- ^ a b c d Austria-Codex (in German). Vienna: Österreichischer Apothekerverlag. 2018.
- ^ Merck Veterinary Manual. Retrieved 2017-03-13.
{{cite book}}:|work=ignored (help) - ^ "Chlortetracycline - DrugBank". Drugbank.ca. Retrieved 2017-03-13.
Chlortetracycline
View on Grokipediafrom Grokipedia
History
Discovery
Chlortetracycline, the first member of the tetracycline class of antibiotics, was discovered in 1945 at Lederle Laboratories (now part of Pfizer) by botanist Benjamin Minge Duggar under the supervision of biochemist Yellapragada Subbarow.[7][8] Duggar's team isolated the compound from the soil bacterium Streptomyces aureofaciens during a systematic effort to identify new antibiotics from actinomycetes, a group of soil-dwelling microorganisms known for producing antimicrobial agents.[9] The bacterium, named for its golden-yellow pigment (aureofaciens deriving from Latin roots meaning "gold maker"), was cultured from a soil sample collected at Sanborn Field, an experimental agronomy plot at the University of Missouri.[10][11] The discovery stemmed from an extensive screening process in which Duggar's group examined over 600 soil samples gathered from across the United States, testing isolates for antibacterial activity.[12] Among these, S. aureofaciens stood out due to the golden pigment it produced, which exhibited potent inhibitory effects against both gram-positive and gram-negative bacteria, surpassing the narrower spectrum of earlier antibiotics like penicillin.[12][13] This broad-spectrum activity positioned chlortetracycline as a significant advancement, particularly effective against pathogens such as rickettsia that penicillin could not target.[14] Emerging in the post-World War II era amid the burgeoning antibiotic revolution, chlortetracycline addressed urgent medical needs following penicillin's wartime success, which had highlighted gaps in treating certain infections.[15] The compound was first reported in the scientific literature in 1948, establishing it as the inaugural broad-spectrum antibiotic beyond penicillin's limitations.[16][12] This breakthrough paved the way for subsequent tetracyclines, such as oxytetracycline isolated shortly thereafter.[14]Commercial development
Chlortetracycline, isolated from the soil bacterium Streptomyces aureofaciens, was unveiled to the scientific community on July 21, 1948, at a conference hosted by the New York Academy of Sciences, where it was introduced under the trade name Aureomycin by researchers from Lederle Laboratories.[12][17] This presentation highlighted its broad-spectrum antibacterial properties, marking the first public disclosure of a tetracycline-class antibiotic.[18] The U.S. Food and Drug Administration (FDA) approved Aureomycin for human use in December 1948, establishing it as the inaugural tetracycline antibiotic and initially targeting rickettsial infections such as Rocky Mountain spotted fever.[19][20] Early applications focused on its efficacy against rickettsiae and chlamydia, filling a critical gap in treatments for these pathogens.[21] Lederle Laboratories swiftly scaled up production following approval, optimizing fermentation processes with Streptomyces aureofaciens to enable industrial-scale output by 1949, which supported both medical and emerging non-therapeutic uses.[22][23] Concurrently, early clinical trials from 1948 to 1950 demonstrated its effectiveness in treating pneumococcal pneumonia, urinary tract infections, and trachoma, with success rates often exceeding 80% in controlled studies.[24][25][26] By 1950, veterinary applications expanded, showing benefits in managing bovine infectious diseases.[27] The compound's generic name, chlortetracycline, reflects its structural feature of a chlorine atom at the 7-position on the tetracycline core, a nomenclature formalized in the late 1940s amid patent filings for its production methods.[22][28] In the 1950s, its discovery as a growth promoter revolutionized animal agriculture, with subtherapeutic doses incorporated into poultry and livestock feeds to enhance feed efficiency and weight gain, leading to widespread adoption across U.S. farms.[29][23] This application, first noted in 1949 experiments at Lederle, boosted industry productivity but also initiated debates on long-term antimicrobial use.[30]Chemistry
Molecular structure
Chlortetracycline has the molecular formula C₂₂H₂₃ClN₂O₈ and a molar mass of 478.88 g/mol.[31] It features a core tetracyclic naphthacene ring system characteristic of the tetracycline class, distinguished by a chlorine atom at the 7-position, which differentiates it from the parent compound tetracycline that lacks this substituent.[31][32] Key functional groups include a dimethylamino group at C4, hydroxyl groups at C10 and C12, and a tricarbonyl system that undergoes enol-keto tautomerism, particularly between C11 and C12, facilitating metal ion chelation.[31][33] The molecule exhibits specific stereochemistry at multiple chiral centers, including the (4S,4aS,5aS,6S,12aR) configuration, with the stereochemistry confirmed by X-ray crystallography of its hydrochloride form (Donohue et al., 1963), as part of the structure elucidation by the Pfizer-Woodward group in 1952.[31][34] Chlortetracycline serves as the parent compound in the tetracycline family; catalytic hydrogenation removes the chlorine atom at C7 to yield tetracycline.[32][35] These structural features contribute to its physical properties: chlortetracycline appears as a yellow crystalline solid, exhibits solubility in water primarily as the hydrochloride salt, and displays fluorescence under ultraviolet light due to its conjugated ring system.[36][37] It is biosynthesized by Streptomyces aureofaciens.[31]Biosynthesis and production
Chlortetracycline is naturally biosynthesized by the bacterium Streptomyces aureofaciens through a type II polyketide synthase (PKS) pathway, which assembles the core structure from simple precursors. The process initiates with the iterative decarboxylative condensation of malonyl-CoA extender units by PKS enzymes, forming a linear poly-β-ketone chain known as the nonaketide. This chain undergoes subsequent modifications, including aromatization and region-selective cyclization by dedicated cyclase enzymes, to establish the characteristic linearly fused tetracyclic scaffold of the tetracycline family. A critical final step involves the regioselective chlorination at the C7 position, catalyzed by the FADH₂-dependent halogenase CtcP, which incorporates chloride from the medium to yield the active antibiotic.[38] The biosynthetic machinery is encoded within the ctc gene cluster of S. aureofaciens, a 43.9 kb region containing 35 open reading frames (ORFs), of which 28 are directly involved in tetracycline scaffold formation and modifications (GenBank: HM627755). Key genes include ctcP, encoding the halogenase for chlorination, and ctcQ, which produces the associated flavin reductase to supply the cofactor FADH₂. Homologous genes to the oxy cluster found in oxytetracycline producers, such as those for oxygenases (e.g., OxyJ and OxyK for hydroxylation steps), contribute to post-PKS tailoring of the scaffold, including methylation and glycosylation to enhance stability and bioactivity. This cluster's organization reflects the modular nature of bacterial aromatic polyketide biosynthesis, with regulatory elements ensuring coordinated expression during late growth phases.[38][39] Industrial production of chlortetracycline relies on submerged aerobic fermentation of engineered S. aureofaciens strains in large-scale bioreactors, typically spanning 90–120 hours. The fermentation medium consists of carbon sources like glucose or starch (20–40 g/L), nitrogen-rich components such as soybean or peanut meal (10–30 g/L), and inorganic salts including calcium carbonate for pH control, magnesium sulfate, potassium phosphate, and sodium chloride to support microbial growth and enzyme activity. Optimal conditions include temperatures of 26–30°C, vigorous aeration (0.5–1 kg/cm² sterile air), and pH maintenance around 6.5–7.5 via antifoam agents and base additions. Through strain engineering, such as overexpression of the ctcP halogenase and optimization of precursor supply, yields have been elevated to approximately 15 g/L of chlortetracycline, predominantly as the hydrochloride salt, representing a significant improvement over wild-type strains. Recent advances include the engineering of Streptomyces aureofaciens J1-022 as a versatile chassis for efficient production of diverse type II polyketides, enhancing yields and applicability as of 2025.[40][38][41] Downstream purification begins with acidification of the fermented broth to pH 2–4 to release the antibiotic from the mycelium, followed by filtration to remove biomass. The crude extract is then subjected to solvent extraction using organic phases like butanol, methanol, or 2-ethoxyethanol at pH 4–7.5 in the presence of bases such as triethylamine to solubilize the neutral form. Precipitation as the hydrochloride salt occurs upon pH adjustment with hydrochloric acid and dilution with water, yielding a solid that is collected by filtration. Final purification involves recrystallization by cooling the solution (e.g., to 4°C) and washing the crystals with aqueous methanol or ethanol, followed by drying under vacuum, achieving purities exceeding 90% with potencies up to 1030 μg/mg. Modern approaches incorporate genetic engineering of Streptomyces hosts to reduce impurities and enhance overall recovery efficiency.[42] Although total chemical synthesis of chlortetracycline has been achieved, it demands over 20 steps to navigate the molecule's dense polar functionality and stereochemical complexity across four fused rings, rendering it economically unviable for large-scale production. Partial semisynthesis from related fermentation products, such as oxytetracycline, has been investigated, involving enzymatic or chemical introduction of the C7 chlorine via heterologous expression of halogenases like CtcP in hosts such as Saccharomyces cerevisiae, yielding up to 36 mg/L of modified tetracyclines. However, due to these challenges, commercial production remains predominantly fermentation-based, leveraging microbial efficiency for the core scaffold assembly.[43][44] Fermentation waste from chlortetracycline production poses risks of antibiotic pollution, as residual tetracyclines can persist in effluents and accumulate in aquatic ecosystems, promoting antimicrobial resistance and disrupting microbial communities. Effective waste management strategies include anaerobic or advanced oxidation treatment of spent broth to degrade antibiotics below detectable limits (e.g., <1 μg/L), prior to discharge, alongside recycling of biomass and salts to minimize environmental release. These measures are essential to mitigate ecological impacts, such as bioaccumulation in sediments and inhibition of nitrogen-cycling bacteria.[45]Pharmacology
Mechanism of action
Chlortetracycline exerts its bacteriostatic effect by reversibly binding to the 30S subunit of the bacterial ribosome at the aminoacyl (A) site, thereby preventing the attachment of aminoacyl-tRNA to this site during the elongation phase of protein synthesis.[46] This inhibition disrupts the translation process, halting the addition of new amino acids to the growing polypeptide chain and ultimately suppressing bacterial proliferation without directly killing the cells.[47] At the molecular level, chlortetracycline interacts specifically with the 16S ribosomal RNA (rRNA) within the 30S subunit, forming hydrogen bonds—particularly with nucleotides such as A965 and G966—and van der Waals contacts that stabilize its position in the A site.[48] These interactions distort the codon-anticodon recognition mechanism, further impeding the accurate pairing and accommodation of tRNA, which leads to premature termination of peptide chain elongation.[49] The conserved nature of these ribosomal binding sites across bacterial species underpins chlortetracycline's broad-spectrum activity against Gram-positive and Gram-negative bacteria, as well as atypical pathogens like Chlamydia and Mycoplasma, rickettsiae, and certain protozoa.[47] Bacterial resistance to chlortetracycline primarily arises through mechanisms such as energy-dependent efflux pumps, exemplified by TetA, which actively export the antibiotic from the cell, and ribosomal protection proteins like TetM, which bind to the ribosome and displace the drug from its site.[50] In therapeutic doses, chlortetracycline exhibits low toxicity to mammalian cells because eukaryotic ribosomes are 80S structures with distinct rRNA sequences and conformations that differ from the prokaryotic 70S ribosomes, resulting in weaker binding affinity and minimal inhibition of host protein synthesis.[51] Additionally, chlortetracycline's ability to chelate divalent cations such as Ca²⁺ and Mg²⁺ contributes to ancillary anti-inflammatory effects by interfering with cation-dependent enzymatic processes in inflammatory pathways.[52] The polycyclic structure of chlortetracycline facilitates these precise ribosomal and chelation interactions.[48]Pharmacokinetics
Chlortetracycline is absorbed primarily in the upper small intestine following oral administration, with an oral bioavailability of approximately 30% in humans when taken on an empty stomach.[53] Peak plasma concentrations are typically reached 2-4 hours after dosing.[54] Topical formulations, such as ophthalmic ointments, provide local absorption in ocular tissues with minimal systemic exposure.[55] The drug distributes widely to various tissues, including the liver, kidneys, lungs, spleen, and bone, with a volume of distribution of about 100 liters.[46] Plasma protein binding is moderate, ranging from 50% to 55%.[46] Chlortetracycline crosses the placenta, potentially affecting fetal development, but exhibits poor penetration into the cerebrospinal fluid due to its limited lipid solubility.[54] Metabolism of chlortetracycline is minimal, with the majority of the drug excreted unchanged; a small portion may form the metabolite 4-epichlortetracycline in some species.[46] The elimination half-life is approximately 5-6 hours in humans.[46] Excretion occurs via both renal (glomerular filtration and tubular secretion) and biliary/fecal routes, primarily fecal overall, with renal excretion accounting for 35–60% of the absorbed drug (approximately 10–20% of the oral dose) over 72 hours in humans.[53][56] In animals, biliary excretion predominates in some species, such as rats where over 90% is eliminated in feces.[53] Pharmacokinetic parameters vary across species; in cattle, extensive ruminal degradation by microbial flora significantly reduces systemic absorption and bioavailability compared to monogastric animals.[54] Intravenous administration in cattle reveals rapid clearance, with a half-life of about 3 hours.[57] Overall half-lives in animals range from 6 to 12 hours or longer, depending on age and species.[54] Absorption is notably impaired by factors such as dairy products, which can reduce bioavailability by 50-70% through calcium chelation.[54] Similar reductions occur with antacids, iron, or aluminum-containing compounds.[54]Medical uses
Human medicine
Chlortetracycline is primarily employed in human medicine as a topical agent for treating skin infections and inflammatory dermatoses. A 3% chlortetracycline hydrochloride ointment is approved for over-the-counter use as a first aid antibiotic to prevent infection in minor cuts, scrapes, and burns.[58] In ophthalmology, chlortetracycline 1% eye ointment serves as a therapeutic alternative to tetracycline for managing bacterial conjunctivitis and trachoma, particularly in endemic regions. It is included on the World Health Organization's Model List of Essential Medicines for trachoma control, where it is applied to the affected eye to target Chlamydia trachomatis infections and reduce active disease prevalence.[59][60] Historically, during the 1950s and 1960s, chlortetracycline was administered systemically via oral or intravenous routes for a range of bacterial infections, leveraging its broad-spectrum activity against gram-positive and gram-negative pathogens, rickettsiae, and certain intracellular bacteria. It was notably effective against respiratory tract infections such as pneumonia, urinary tract infections, brucellosis, and rickettsial diseases including typhus. Typical historical oral dosing ranged from 250 to 500 mg every 6 hours, while intravenous administration followed similar regimens adjusted for severity.[47][14] Currently, systemic use of chlortetracycline in humans is rare, largely supplanted by more bioavailable alternatives like doxycycline due to improved pharmacokinetics and reduced resistance concerns. It remains relevant topically and ophthalmically in resource-limited settings for trachoma management.[61] Its limited first-line status stems from widespread bacterial resistance, primarily mediated by efflux pumps and ribosomal protection, as well as associated photosensitivity that restricts utility in ambulatory patients.Veterinary medicine
Chlortetracycline is commonly used in veterinary medicine to treat respiratory diseases such as shipping fever in cattle, caused by Pasteurella multocida, as well as bacterial enteritis in pigs due to Escherichia coli and conjunctivitis in cats, dogs, and horses.[63][64][65] In poultry and livestock, it is added to feed at concentrations of 10-200 g per ton to prevent chronic respiratory disease in chickens associated with Mycoplasma gallisepticum.[66][67] Specific formulations include soluble powder for administration in drinking water, such as 400 mg per gallon for calves to treat bacterial pneumonia, and intramammary infusions containing 100-200 mg per quarter for managing mastitis in dairy cows caused by susceptible bacteria like Streptococcus agalactiae.[68][69] Dosing regimens vary by species; for example, dogs receive 10 mg per pound of body weight per day orally for susceptible infections, while pigs are treated at 10 mg per pound via medicated water. Withdrawal periods are established to prevent residues, such as 5 days before slaughter for meat in pigs and 24-48 hours for cattle and poultry depending on the formulation.[54][68][70] The U.S. Food and Drug Administration (FDA) has approved chlortetracycline for use in food-producing animals under the Veterinary Feed Directive (VFD), requiring veterinary oversight to mitigate antimicrobial resistance risks, with ongoing monitoring in agricultural settings.[4][71][72] Its benefits include cost-effective broad-spectrum control of pathogens like Mycoplasma species, Pasteurella, and Salmonella in livestock, though pharmacokinetic differences in ruminants, such as reduced oral bioavailability due to rumen microbial degradation, necessitate adjusted administration routes.[54][66]Safety
Adverse effects
Chlortetracycline, like other tetracyclines, commonly causes gastrointestinal adverse effects, including nausea, vomiting, diarrhea, and epigastric pain, primarily due to irritation of the gastrointestinal mucosa.[2] These symptoms affect a substantial portion of patients during oral administration.[2] Dermatological reactions to chlortetracycline include photosensitivity, manifesting as exaggerated sunburn-like responses such as redness and blistering upon sun exposure.[2] In children under 8 years and fetuses exposed during pregnancy, the drug can cause permanent yellow-brown tooth discoloration and enamel hypoplasia due to interference with mineralization processes.[46][2] Other common adverse effects encompass hepatotoxicity, evidenced by elevated liver enzymes, particularly in individuals with preexisting liver conditions or those receiving high doses.[2] Renal toxicity is rare but may occur with outdated or degraded preparations; use with caution in patients with compromised kidney function, though chlortetracycline is primarily excreted via feces.[2][46] Serious but rare adverse effects include pseudotumor cerebri, characterized by intracranial hypertension with symptoms like headache and visual disturbances.[2] Allergic reactions range from rash to anaphylaxis in hypersensitive individuals.[2] Superinfections, such as Clostridioides difficile-associated colitis, can arise from disruption of normal gut flora.[2] In veterinary applications, chlortetracycline inhibits bone growth in young animals by chelating calcium and depositing in developing skeletal tissues, potentially leading to deformities if used during periods of rapid growth.[54] In dairy cattle, treatment risks antibiotic residues in milk that pose public health concerns through potential human exposure.[73] Monitoring of liver and kidney function through regular tests is recommended during prolonged chlortetracycline therapy to detect hepatotoxicity or renal impairment early.[2] The drug is classified as FDA Pregnancy Category D, indicating evidence of fetal risk including tooth discoloration and bone growth inhibition, and should be avoided in pregnant women.[74]Contraindications
Chlortetracycline is contraindicated in patients with known hypersensitivity to tetracyclines or any component of the formulation, as it may provoke severe allergic reactions.[2] Systemic administration is absolutely contraindicated in children under 8 years of age due to the risk of permanent discoloration of teeth and enamel hypoplasia.[2] It is also contraindicated during pregnancy, particularly in the second and third trimesters, because of potential adverse effects on fetal bone growth, teeth development, and maternal hepatotoxicity.[2] Use with caution in patients with severe renal impairment (creatinine clearance <30 mL/min) due to potential for rare toxicity, though primary fecal excretion reduces accumulation risk.[2] Similarly, it is contraindicated in severe hepatic impairment owing to the potential for hepatotoxicity and impaired clearance.[2] Relative contraindications include concurrent use with isotretinoin, which increases the risk of pseudotumor cerebri.[75] In special populations, systemic chlortetracycline is contraindicated during breastfeeding due to excretion into milk and potential infant tooth staining and photosensitivity.[76] Caution is advised in elderly patients with dehydration, as it may strain renal function and lead to azotemia.[77] In veterinary medicine, topical application of chlortetracycline on the udders of lactating animals is contraindicated to prevent milk contamination and residues.[78] Systemic use is contraindicated in animals with documented bacterial resistance to tetracyclines, as efficacy is compromised by mechanisms such as efflux pumps.[78] Additionally, since 2006, the European Union has banned the use of chlortetracycline and other antibiotics for growth promotion in animal feed to curb resistance development.[79]Interactions
Drug interactions
Chlortetracycline, as a member of the tetracycline class, can potentiate the anticoagulant effects of warfarin and acenocoumarol by increasing the international normalized ratio (INR), potentially due to inhibition of vitamin K-producing gut bacteria or direct effects on prothrombin activity; close monitoring of prothrombin time (PT) and INR is recommended during concurrent use.[46][80] Concurrent administration with bacteriostatic antibiotics such as penicillins (e.g., amoxicillin) or cephalosporins may result in antagonism, as chlortetracycline's inhibition of bacterial protein synthesis can impair the bactericidal cell wall-targeting action of beta-lactams; combination therapy should be avoided when possible to maintain efficacy.[81][82][64] The risk of pseudotumor cerebri (benign intracranial hypertension) is heightened when chlortetracycline is used with retinoids such as isotretinoin or excessive vitamin A, likely due to additive effects on intracranial pressure; concurrent use is generally contraindicated, and patients should be monitored for symptoms like headache and visual disturbances.[46][83][84] Combination with other antibiotics like aminoglycosides (e.g., gentamicin) requires caution due to potential additive nephrotoxicity; veterinary guidelines advise against routine co-administration unless benefits outweigh risks.[64] Chlortetracycline forms chelates with divalent and trivalent cations in antacids (e.g., those containing aluminum, magnesium, or calcium) and iron supplements, significantly decreasing its gastrointestinal absorption and bioavailability; dosing should be separated by at least 2-3 hours to minimize this pharmacokinetic interaction.[85][86][87] In veterinary medicine, chlortetracycline exhibits synergism with sulfonamides (e.g., sulfadimidine) against certain respiratory pathogens in animals, enhancing antibacterial activity through complementary mechanisms of protein synthesis inhibition and folic acid antagonism; this combination is used for treating infections like enzootic pneumonia in pigs.[88]Interactions with food and labs
Chlortetracycline absorption is significantly reduced when administered with dairy products such as milk and cheese, or other calcium-rich foods, due to the formation of insoluble chelate complexes that impair gastrointestinal uptake. This interaction can decrease bioavailability by 50% to 90%, necessitating avoidance of such foods for at least 1 to 2 hours before and after dosing to optimize therapeutic efficacy.[14][89] Similarly, multivalent cations including aluminum and magnesium found in antacids or supplements, as well as iron in oral preparations, bind to chlortetracycline through chelation, leading to reduced bioavailability comparable to calcium interactions. Administration should be separated by at least 2 hours from these agents to minimize binding and ensure adequate drug absorption.[14][2] Chlortetracycline can interfere with certain laboratory tests, potentially causing false-negative results for urine glucose when using glucose oxidase-based methods such as Clinistix or Tes-Tape, due to direct inhibition of the enzymatic reaction. Additionally, it may elevate blood urea nitrogen (BUN) levels through its anti-anabolic effects, independent of renal impairment, and has been associated with increased serum creatinine in cases of renal toxicity, though creatinine interference is less consistent. The drug's inherent fluorescence properties can also disrupt fluorescent-based assays, such as those measuring catecholamines or other fluorometric endpoints, by contributing background signal or quenching effects.[90][77][91] In veterinary applications, chlortetracycline residues from treated animals can contaminate milk and meat, posing risks of human exposure and contributing to antibiotic resistance; regulatory tolerances for total tetracycline residues limit levels to 2 ppm in muscle, 6 ppm in liver, and 12 ppm in kidney and fat of cattle, with zero tolerance in milk. Withdrawal periods vary by species, dose, and formulation, typically 48 hours for cattle prior to slaughter to ensure residue levels fall below these thresholds, and no use is permitted in lactating dairy cattle to prevent milk contamination.[92][93] No direct pharmacokinetic interaction exists between chlortetracycline and alcohol, but concurrent use may exacerbate gastrointestinal side effects such as nausea and upset due to additive irritant effects on the gut mucosa.[94] The stability of chlortetracycline is enhanced in acidic environments (pH 3-4), where it remains relatively persistent, but it degrades rapidly under alkaline conditions (pH above 5), forming epimers and anhydro products that reduce potency. This pH sensitivity influences formulation choices and storage, particularly in gastrointestinal transit where acidic conditions in the stomach aid initial stability before potential degradation in the intestine.[95][96]References
- https://www.sciencedirect.com/topics/[neuroscience](/page/Neuroscience)/chlortetracycline