According to the latest World Health Organization (WHO) estimates, nearly half of the world’s population lived in malaria endemic areas in 2015 [
1]. The burden of malaria predominantly affects sub-Saharan Africa accounting for 90% of the 212 millions of malaria cases and 90% of the 429,000 deaths. Most of the cases of malaria in 2015 were in Africa (90%). Children are especially vulnerable and represented more than 90% of the malaria cases in Africa. The highest proportion of deaths was averted in Africa (94%). Of the estimated 6.8 million fewer malaria deaths between 2001 and 2015, about 6.6 million (97%) were for children aged under 5 years. In 2015, 303,000 malaria deaths (range: 165,000–450,000) were estimated to have occurred in children aged under 5 years, which is equivalent to 70% of the global total. Malaria remains a major killer of children, taking the life of a child every 2 min. The spread of anti-malarial drug resistance from Southeast Asia to Africa has previously occurred with chloroquine and sulfadoxine–pyrimethamine [
2,
3]. The emergence of resistance to artemisinins, manifested by delayed parasite clearance after monotherapy with artesunate or ACT, was described in Southeast Asia [
4,
5]. Drug resistance is currently emerging even to the most recently commercialized ACT, dihydroartemisinin–piperaquine, in Cambodia, where 84% of treated patients showed delayed parasite clearance half-lives in 2012–2014 [
6‐
8]. Antibiotics, and more specifically doxycycline, have been shown to be effective against malaria parasites [
9‐
11]. Doxycycline is recommended for malaria chemoprophylaxis for travel in endemic areas [
12,
13]. Considering doxycycline delayed onset of action, this finding justifies its therapeutic use in combination with a fast schizonticide [
11]. The addition of doxycycline for severe malaria was much more as an attempt to reduce the emergence of resistance, and reduce the use of artesunate or quinine monotherapy. Doxycycline can alter recrudescent parasites. Additionally, doxycycline can also prevent bacterial infections which could be associated with malaria. Doxycycline is recommended in combination with quinine for malaria treatment in the event of ACT unavailability in some European clinical practice [
14,
15]. This combination is also used when treatment of severe malaria with artesunate fails [
16]. In some African hospitals, oral doxycycline is used systematically in combination with intravenous artesunate in the treatment of severe
P. falciparum malaria [
17]. Additionally, some severe
P. vivax cerebral malaria cases have been treated with artesunate and doxycycline [
18,
19]. However, doxycycline is contraindicated in children under 8 years of age because of the risk of yellow tooth discolouration and dental enamel hypoplasia.
In this review, the potential effects of doxycycline on teeth were re-analysed. Information sources were identified using PubMed, Google Scholar and Google. Searches were performed in these electronic databases using the search term ‘doxycycline’ alone or in combination with ‘teeth’ or ‘children’ or ‘side-effects’.