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Vestibular reactions associated with minocycline
Antimicrobial Agents and Chemotherapy
|October 1, 1975
Summary
Minocycline prophylaxis for meningococcal disease causes significant vestibular side effects in 86% of users. Due to these adverse reactions, 52% discontinued the drug, prompting recommendations for alternative treatments.
Area of Science:
- Pharmacology
- Infectious Disease Epidemiology
- Clinical Toxicology
Background:
- Minocycline is an antibiotic used for meningococcal disease prophylaxis.
- Recent reports suggest a high incidence of vestibular side effects associated with minocycline use.
Purpose of the Study:
- To investigate the incidence and severity of vestibular side effects in individuals receiving minocycline for meningococcal disease prophylaxis.
- To compare adverse reactions in minocycline-treated individuals with a matched control group.
Main Methods:
- A questionnaire-based survey was conducted in January 1975 among hospital staff exposed to a suspected meningococcal meningitis case.
- Twenty-nine staff members who received minocycline and 25 matched controls completed the questionnaire on adverse reactions.
- Data collected included the occurrence, severity, onset, and resolution of vestibular symptoms.
Main Results:
- 86% of the minocycline-treated group experienced moderate to severe vestibular symptoms.
- 84% of symptomatic individuals reported symptom onset after one or two 100 mg doses.
- 52% of treated staff discontinued minocycline due to these side effects, with symptom resolution within 48 hours of cessation.
Conclusions:
- Minocycline is associated with a high incidence of debilitating vestibular side effects when used for meningococcal prophylaxis.
- Rifampin is recommended for meningococcal prophylaxis until minocycline's safety profile is reestablished.
- Alternative medications should be considered for other indications where minocycline is prescribed.
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