As the antibiotic kills pathogenic bacteria, normal flora (bacteria that are normally found in the body) levels are altered. This disruption of normal flora balance and overgrowth of opportunistic bacteria can then lead to a superinfection since competition for resources among bacteria, whether normal flora or pathogens, has shifted due to the selective eradication of certain bacteria during treatment. Examples include fungal infections of the mouth, pharynx, vagina and bowels from overgrowth of normal flora.
Infection with Clostridioides difficile may result with the use of tetracycline antibiotics. C. diff often causes a pseudomembranous colitis. This occurs because the antibiotic kills off pathogenic bacteria, letting intestinal flora that normally exists in only small amounts to grow out of proportion.
Tetracyclines are considered teratogens due to the strong association with teeth discoloration in the fetus and developing infant. It may result in permanent staining of teeth characterized by dark, yellow, gray teeth with a horizontal band across the bottom and top rows.
These drugs are known to be associated with inhibition of bone growth in children when given in therapeutically high doses.
An important side effect of tetracyclines is photosensitivity, as they can increase the risk of sunburn under exposure to light. This side effect is of particular importance for patients that use this class of medication for long-term malaria prophylaxis, as it can cause permanent sensitivity and sun damage.
This drug class should not be given to children under the age of 8, as these medications can lead to teeth discoloration and inhibited bone growth in children.
Use of tetracyclines in pregnancy is contraindicated due to the teratogenic effects exhibited. These include inhibition of bone growth as well as characteristic teeth discoloration.
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