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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
PubMed

Insights

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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