Microbial infections tetracycline

Resistance to Tetracyclines. The tetracyclines stiU provide inexpensive and effective treatment for several microbial infections, but the emergence of acquired resistance to this class of antibiotic has limited their clinical usehilness. Studies to define the molecular basis of resistance are underway so that derivatives having improved antibacterial spectra and less susceptibiUty to bacterial resistance may be developed. Tetracyclines are antibiotics of choice for relatively few human infections encountered in daily clinical practice (104), largely as a result of the emergence of acquired tetracycline-resistance among clinically important bacteria (88,105,106). Acquired resistance occurs when resistant strains emerge from previously sensitive bacterial populations by acquisition of resistance genes which usually reside in plasmids and/or transposons (88,106,107). Furthermore, resistance deterrninants contained in transposons spread to, and become estabUshed in, diverse bacterial species (106). 

SJS was for many years considered a severe variant of erythema multiforme major (EMM) however, over the past decade some experts have reclassified SJS as a less severe variant of toxic epidermal necrolysis (TEN) rather than a form of EMM. However, this perspective is not universally accepted. SJS occurs acutely in all ages, with 20% in children and a peak incidence in adults between the second and fourth decades of life. SJS is a potentially fatal disorder with a mortality of approximately 5%.TEN has a mortality rate of approximately 30%. About 50% of cases of these disorders are idiopathic. Identifiable causal factors include microbial infection, particularly with Mycoplasma pneumoniae and HS Vj and medications, including sulfonamides, tetracycline, penicillin, nonsteroidal anti-inflammatory drugs (NSAIDs), psychotropic agents, antiepileptics, and immunizing vaccines. Recent research suggests that HSV infection is a principal fector in the genesis of EMM, whereas medications are a more likely precipitant of SJS and TEN. 

The objective of antibiotic treatments is to reduce the density of microbial pathogen in infected udder tissues and thereby improve the capacity of the animal s immune system to deal with the infection. The effect of a successful antibiotic treatment is therefore self-cure of mastitis (Hamann and Kromker, 1999). However, some antibiotics (e.g. tetracycline and gentamycine) may also have negative side effects on the animal s immune response to udder infection, as they have been shown to inhibit/reduce phagocytosis of the animal s own defence cells (Nickerson et al 1986). 

Although the clinical usefulness of tetracyclines is limited for most of the common microbial pathogens, they remain drugs of choice (or very effective alternative therapy) for a wide variety of infections caused by less common pathogens. These include brucellosis rickettsial infections such as Rocky Mountain spotted fever, typhus, and Q fever Mycoplasma pneumonia cholera plague Ureaplasma urethritis Chlamydia infections and Lyme disease. Oral doxycycline, 100 mg orally twice a day for 7 days, is a recommended treatment for chlamydial sexually transmitted disease. 

Tetracyclines have many effects on non-infective inflammatory processes (SEDA-24, 278). They have been tried, and claimed to be of some value, in the treatment of rheumatoid arthritis, periodontal disease, myocardial infections, gastric disorders, and experimentally in the treatment of cancers. In all of these disorders, the proposed mechanisms for effects are on the host rather than the microbial side. 

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