Irishcheer- I am planning on taking Doxy for my trip to Siem Reap in January and chose it because I've already been on tetracycline, in the same medication family, for many years for rosecea. Yes, I am sun sensitive and being genetically half red head (Irish!) doesn't help either but overall, I use a good sunblock, cover myself and just plain practice common sense when planning trips where I'll be outdoors. You'll know if the medication is getting to your skin because it will sting a little. I've been on tetracycline for many years with no problems since I do practice safe-sun. Doxy will replace the tetra for me so I'll be taking it as a preventative for two things at once- what a bargain!
**TWO IMPORTANT POINTS ABOUT DOXYCYCLINE- one is to find out if its taken on an empty stomach or not as that makes a big difference in stomach upset and medication absorbtion. Secondly, if you are a female, be aware of a yeast infection possibility!!! Going on and off this family of meds makes women VERY suspectible to yeast infections. Believe me, I know as I went off tetracyline once when an MD told me too and even weaning off it over the course of a few days wasn't slow enough and WHAM! So plan to go on it say a month in advance and go off it very, very slowly AND have some yeast infection medication ready to go if you need it. This is the first thing I will pack when I go to Siem Reap as I don't want to be looking around for an over the counter medication that may not be available there!

Cookiew, Doxy should not be taken on an empty stomach. Take it with food, at approximately the same time each day. You must continue to take the doxy for one month after you leave the malarial risk area. There is no need to "wean" off doxy - it has a very short half-life.

Some women do get yeast infections from taking an antibiotic, so it is wise to take medication along just in case. Your experience of only getting a yeast infection when you stopped the doxy is unusual. It isn't the stopping, it's taking the doxy that can cause yeast infections.

Doxycycline may be taken on an empty stomach.

http://www.medicinenet.com/minocycline-oral/article.htm

<HOW TO USE: This medication may be taken with food or on an empty stomach.>

Jed, I suppose I should have specified that doxy should be taken with food to reduce the chances of stomach upset.

Yes, http://www.nlm.nih.gov/medlineplus/d...r/a682063.html

says: <If your stomach becomes upset when you take doxycycline, you may take it with food or milk.>

Kathie, are you a doctor?

I am just asking because I recently returned from 3 mths in Africa and not only did two of the young people with whom I worked and who diligently took Malarone come down with malaria, the local doctors sad that malarone merely reduces the severity of malaria should you contract it.

I called the cdc about this and they doubted every aspect of what i told them: they doubted the kids had malaria (despite the confirmed tests); they doubted they took their meds (despite the fact that they were public health students and very careful about meds); they doubted that the african doctors were telling the truth about malarone- and one of the doctors was so respected he was addressing the hiv/aids conference in toronto and ran a clinic that covered an entire region of the country.

what's my point? people need to really carefully research everything both at home and locally where they are going and take every precaution not to be bitten in addition to taking anti malarials- i am not a doctor but have taken anti malarials on at least 7 different trips.

i also think nany of the symptoms everyone is attributing to their meds- dizzyness fatigue, diarrhea are also common when you change climates or time zones or food intake or water intake.

i would not discontinue malaria meds for any reason without consulting a physician - and locals are a lot more knowledgable about malaria in their countries than the cdc in air conditioned atlanta!

and i am so sorry for the original poster- how horrible and frightening! i am glad you are better now.

Folks taking the meds just need to realize that they can still come down with malaria while taking the meds... it's not total protection. As I stated, my best friend who was strict about taking the meds came down with cerebral malaria in Senegal. Happy Travels!

kerikeri,
I'm not a physician but an allied health professional who worked in a hospital for 23 years before going into private practice. Tropical medicine has long been an interest of mine (especially because I like to travel!) so I keep up on the research and clinical issues.

No anti-malarial is 100% effective. Indeed, no medication of any sort is 100% effective. So it is absolutely true that people must be vigilant about reducing exposure to mosquito bites and must be vigilant for symptoms of malaria even if they have been taking anti-malarials.

Malarone has an effectiveness of approximately 95%, as do larium, and doxycycline. (Some studies suggest doxy may be slightly lower, perhaps in the 92-93% range; some studies suggest that the effectiveness formalarone is slightly higher).

Two people in your group getting malaria even though they were taking malarone is statistically very unlikely, but it can happen. I expect the cdc person wondered aloud whether they had been taking their pills daily and wondered about the reliability of the malaria blood tests used.

Note that it is NOT true "that malarone merely reduces the severity of malaria should you contract it." Malarone does prevent a person from developing malaris if bitten by a mosquito carrying malaria. In those rare cases where someone develops malaria in spite of taking malarone (or another effective anti-malarial) it is true that their symptoms will often be less severe.

Your points about people attributing all symptoms to taking an anti-malarial are so true!

I'm afraid I disagree about local doctors necessarily knowing more about malaria than the cdc or WHO. One advantage that the cdc and WHO have is that they have world-wide data. But the data is only as good as the people reporting the data. I do hope the physician in Africa made the reports of the two cases in people taking malarone. As you probably know, resistance to particular medications is a major issue with malaria. Health care professionals have worked hard to limit the use of malarone to help prevent development of malarone-resistant strains of malaria. WHile two cases in such a short time may merelt be a statistical anomoly, it may also be a red flag for the development of a malarone-resistant strain. There have been a couple of similar instances reported in Africa, so this wouldd be alarming.

i'm glad i asked!

that was the point i wanted to follow up on if your were a med professional: how could it be true that these two kids each got malaria and each in separate towns at separate points on the journey were tested positive for malaria and yet the cdc completely refused to acknowledge this.

i spoke directly to a doctor at the "malaria" line (i left a message and he returned the call promptly).

i was baffled by the response which was essentially that they needed the scenario to have occured in lab cinditions. when would that ever occur in real life?

it just irked me so much that this happened and that the cdc and naturally other medical bodies are set up to ignore this because it didn't happen in a lab.

it made me feel like i would never trust what they said again since i had seen with my own eyes that what they were saying was so was not so.

i also felt his attitude was "it happened in africa so it didn;t really happen."

i wish i knew what else to do...anyway thanks for your response and to the other person with the friend who also contracted malaria under treatment.

how are we to rpotect ourselves if the cdec must have clinical results and discounts anecdotal ones?

The cdc doesn't completely discount anecdotal data. Both the WHO and cdc collect info on all such incidents through their reporting mechanisms. But I'm sure that calling them with this info was extremely frustrating and I'm sure you felt disregarded. Their concerns are more epidemologic while yours are clinical and personal, so I'm sure it felt like you weren't communicating with each other.

Well said! Happy Travels!

KoreaPrincess, I so hope your ordeal is over. Wanted to tell you what an invaluable addition to this site you story is. Thank you so much for sharing.
I too had an as yet undiagnosed illness 9 years ago that put me in the hospital and wheelchair and I ended up on Prednisnone ( life saving for the pain but terrible stuff in the long run) - I had been in Japan and though again I was never given a diagnosis it was thought I picked up something from raw seafood that attacked my immune system.
I was basically out of commision for at least a year, even went to Mayo Clinic but no one could tell me what I had contracted, only that every joint in my body was inflamed and skreeching painful. Pleased to say I am 98% recovered today and enjoy every moment I have and, have not been at all disuaded from going back to SEA.

Again I wish you total recovery and thank you for all the valuable information you have given us all.
Sue

Dear Sue, I am happy to tell you that after months of feeling so unwell, I am, like yourself, about 98% recovered. My muscles were so weak, as steroids damage muscle cells and I am trying to regain that strength back. Of course, the prednisone also put on weight (which I did not need), but my "moonface" has disappeared and I just started walking. I am from the US, but living in Korea. We live in Busan, near a beautiful beach and I just discovered an easy way to get down there and walk along the boardwalk. A few months ago I thought I'd never feel normal again, but I do.Sadly, my vision in my eye right eye has never gotten back to normal after the retina surgery. This distresses me as I always had perfect vision. I was told I need more surgery to remove scar tissue over the retina, but I wasn't up to another surgery just yet. I'm taking lots of vitamins and supplements even trying "noni" which I bought in Hawaii this summer. My husband has been offered the possibility of a job in Fujian province, China and we are considering it. So I too am ready to continueour adventure in SEA! Thanks to everyone who wished me well and good health to you all! Pat Wilson (koreaprincess)

I'm so glad to hear that you are feeling better. I know that recovery from this sort of serious illness takes time. My best wished for your continued recovery.