Intravenous Minocycline: A Review in Acinetobacter Infections.
Sarah L Greig1, Lesley J Scott2
1Springer, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand. demail@springer.com.
Drugs
|August 31, 2016
Summary
Intravenous minocycline shows promise for treating multidrug-resistant Acinetobacter baumannii infections. Clinical data suggest it is well-tolerated and effective, especially when combined with other antibiotics.
Area of Science:
- Infectious Diseases
- Pharmacology
- Microbiology
Background:
- Acinetobacter baumannii is a significant cause of hospital-acquired infections, often exhibiting multidrug resistance (MDR).
- The emergence of extensively drug-resistant (XDR) A. baumannii necessitates novel therapeutic strategies.
- Intravenous minocycline, a synthetic tetracycline derivative, has been repurposed to address this challenge.
Purpose of the Study:
- To evaluate the efficacy and tolerability of intravenous minocycline in treating MDR and XDR Acinetobacter spp. infections.
- To assess the synergistic activity of minocycline in combination with other antibacterial agents against resistant A. baumannii strains.
- To review current clinical data supporting the use of minocycline for challenging Acinetobacter infections.
Main Methods:
- Review of retrospective studies and clinical data on intravenous minocycline use.
- Assessment of in vitro antibacterial activity and synergistic effects against Acinetobacter baumannii isolates.
- Analysis of clinical outcomes, including success rates and adverse events in patients with MDR/XDR infections.
Main Results:
- Minocycline demonstrates broad antibacterial activity against global A. baumannii clinical isolates.
- Synergistic bactericidal activity was observed when minocycline was combined with other antibiotics against MDR/XDR strains.
- Retrospective studies reported high clinical success or improvement rates with intravenous minocycline in patients with MDR A. baumannii infections, with good tolerability.
Conclusions:
- Intravenous minocycline presents a potential therapeutic option for MDR Acinetobacter baumannii infections.
- Combination therapy, particularly with agents like colistin, may enhance minocycline's effectiveness.
- Further randomized clinical trial data are needed, though challenging to conduct, to solidify minocycline's role in treating these difficult-to-treat infections.
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