Intended for healthcare professionals

Rapid response to:


Covid-19: what treatments are being investigated?

BMJ 2020; 368 doi: (Published 26 March 2020) Cite this as: BMJ 2020;368:m1252

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Rapid Response:

Doxycycline for COVID-19 Prophylaxis in NHS Frontline Workers

Dear Editor,

To Whom it May Concern,

I would like to propose that frontline NHS healthcare workers take the antibiotic Doxycycline (1) prophylactically to prevent COVID-19 infections in hospital and GP settings nationwide. For example, they could take 100-mg of Doxycycline per day.

Doxycycline is widely and readily available in the United Kingdom and world-wide. The cost would be minimal, less than 10 pence a day per person. Since it is already MHRA-approved for bacterial infections, it can also be prescribed legally by consultants and GPs, in an off-licence fashion.

Doxycycline has previously been shown to inhibit the replication of other viruses, such as the Dengue virus (2), among others, because it is an inhibitor of protein synthesis. It also inhibits the production of inflammatory cytokines, such as IL-6 (3), that are activated in COVID-19 patients.

Doxycycline is a very safe drug, which was first FDA-approved in 1967, over 50 years ago. It is already used for the prevention of acne and malaria, as well as many other bacterial infections. Bacterial super-infection is a major complication of viral infections and was the major cause of mortality during the influenza pandemic of 1918 (4, 5).

Also, NICE has already designated Doxycycline as the treatment of choice for community acquired pneumonia, during the COVID-19 pandemic:

Thank you for considering this inexpensive approach to preventing ongoing viral transmission during the COVID-19 pandemic, using Doxycycline prophylaxis.

Best wishes,

Professor Michael P. Lisanti, MD-PhD, FRSA, FRSB
Chair, Translational Medicine
University of Salford

Supporting Evidence

1. COVID-19 and Chronological Aging: Senolytics and Other Anti-Aging Drugs for the Treatment or Prevention of Corona Virus Infection?

2. Inhibitory Effect of Doxycycline Against Dengue Virus Replication in Vitro

3. Dengue Patients Treated with Doxycycline Showed Lower Mortality Associated to a Reduction in IL-6 and TNF Levels.

4. Predominant role of bacterial pneumonia as a cause of death in pandemic influenza: implications for pandemic influenza preparedness.

5. Bacterial Pneumonia Caused Most Deaths in 1918 Influenza Pandemic (Press Release from NIH by Dr. Anthony Fauci in 2008)

Competing interests: No competing interests

24 April 2020
Michael P Lisanti, MD-PhD, FRSA, FRSB
Professor and Chair, Translational Medicine
University of Salford
43 Crescent, School of Science, Engineering and Environment, Greater Manchester, M5 4WT