Naval Medical Research Center (NMRC) scientists presented their research, “A meta-analysis of doxycycline as an adjunctive therapy to prevent decompression sickness (DCS)” during the Military Health System Research Symposium (MHSRS) in Kissimmee, Florida Aug. 20.

During their presentation, they explained how a supplement therapy compatible with recompression therapy can reduce DCS associated diseases and death among Navy divers, and operators of diving and disabled submarine rescue (DISSUB) waiting treatment.

According to Divers Alert Network, DCS are injuries caused by a rapid decrease in the pressure that surrounds a person, either air or water. In some cases, the disease is mild and not an immediate threat. In other cases, serious injury does occur; if this happens, the quicker the treatment begins, the better an individual has for full recovery.

 “DCS is an ever-present risk in operational diving and DISSUB scenarios. While recompression therapy is the gold standard for treating DCS, adequate chamber capacity might not be available during operations with a large number of casualties, or in remote locations, and DISSUB rescuees might need to transfer to recompression chambers at surface pressures,” said Lt. Rainey Johnson, undersea medical officer. “Considering these factors we chose to try a common and inexpensive FDA approved antibiotic. In this case Doxycycline, to give divers better treatment and time. The drug prevents DCS severity by inhibiting matrix metalloproteinases and modifying leukocyte responses.”

Johnson explained how the meta-analysis was based on three sets of similar hyperbaric data evaluating doxycycline’s effect on DCS associated diseases and mortality. The primary evaluating factor was mortality. The secondary evaluating factor includes the occurrence of cardiovascular and neurologic DCS. The third estimating factor included time to death based on cardiovascular and neurologic DCS.

“Time to these events are important as increased inactivity allow for additional life saving measures to occur,” Johnson said.

Johnson and his colleagues, conclude doxycycline reduces mortality, although this effect was not statistical significant.

“Adjusting study effect is essential for multiple studies analysis.” said Johnson. “Future studies are underway incorporating doxycycline prophylaxis in a simulated DISSUB scenario decompressed from saturation. If worthwhile, the results from this and the follow on studies will be communicated to NAVSEA to support submarine rescue in the event of a DISSUB scenario.”

About Naval Medical Research Center

NMRC's eight laboratories are engaged in a broad spectrum of activity from basic science in the laboratory to field studies at sites in austere and remote areas of the world to operational environments. In support of the Navy, Marine Corps, and joint U.S. warfighters, researchers study infectious diseases, biological warfare detection and defense, combat casualty care, environmental health concerns, aerospace and undersea medicine, medical modeling, simulation and operational mission support, and epidemiology and behavioral sciences.

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