An 11-year-old boy with a respiratory condition needing medication to manage exacerbations. Which medicine should be avoided?

• A. Salbutamol
• B. Beclomethasone
• C. Doxycycline
• D. Azithromycin

Answer: (C)

Doxycycline should be avoided in this age group because it is a tetracycline antibiotic with effects on growing teeth and bones. When given to children during tooth development, it can cause permanent discoloration of the teeth and enamel defects. It can also affect bone growth by binding calcium. For an 11-year-old, these safety concerns make doxycycline unsuitable for managing respiratory conditions, especially since common therapies like a fast-acting bronchodilator for exacerbations and an inhaled corticosteroid for control are preferred. Antibiotics are only used if there is a bacterial infection, and while other antibiotics like azithromycin may be considered in specific scenarios, doxycycline’s potential to stain teeth and affect bone growth is the reason it’s avoided here.