Vol. 7, Issue 2, Part F (2025)

Doxycycline, a widely prescribed antibiotic, is a leading cause of drug-induced esophagitis resulting from direct chemical injury to the esophageal mucosa. We present the case of a 24-year-old male on doxycycline for acne who developed acute retrosternal chest pain and severe odynophagia. His symptoms began shortly after ingesting the medication with minimal fluid before lying down. After excluding cardiopulmonary etiologies, an urgent upper endoscopy revealed a distinct ulcer in the mid-esophagus, confirming the diagnosis. The offending drug was discontinued, and supportive care with a proton pump inhibitor was initiated, leading to a rapid and complete resolution of symptoms. This case underscores that doxycycline-induced esophagitis is an entirely preventable iatrogenic condition. It highlights the critical importance of patient counseling by clinicians on proper medication administration specifically, taking pills with a full glass of water and remaining upright to prevent this painful adverse event and its associated healthcare burden.