Minocycline infection

A combination of amphotericin B, miconazole (16), and rifampin (17) was used to successfully cure one patient. In addition, tetracycline (7) and minocycline (18) have been recommended although their clinical efficacy have not been estabUshed. No proven therapeutic agents exist for treating A.catbamoeba infections, however, the phenothiazines, trifluoperazine [117-89-5] and chlorpromazine [50-53-3], show promise in vitro. 

Tetracycline Demeclocy dine, minocycline, and tetracycline Syphilis, chlamydial infections and Lyme disease, mycoplasmal diseases and acne rickettsial infections... 

Another group of compounds, the tetracyclines, are made by fermentation procedures or by chemical modifications of the natural product. The hydrochloride salts are used most commonly for oral administration and are usually encapsulated because of their bitter taste. Controlled catalytic hydrogenolysis of chlortetracycline, a natural product, selectively removes the 7-chloro atom and produces tetracycline. Doxycycline and minocycline are other important antibacterials. Tetracycline can be prescribed for people allergic to penicillin. Doxycycline prevents traveler s diarrhea. Tetracyclines help many infections including Rocky Mountain spotted fever, Lyme disease, urinary tract infections, bronchitis, amoebic dysentery, and acne. 

Photosensitivity, observed as abnormal sunburn reaction, is particularly associated with demeclocychne and doxycychne administration. Superinfection may result in oral, anogenital, and intestinal Candida albicans infections, whereas Staphylococcus aureus or Clostridium difficile overgrowth may cause enterocolitis. Minocycline can produce vertigo. 

It is used orally for intestinal candidiasis, topically for oral, vaginal and cutaneous candidiasis and hospital treatment of progressive and potentially fatal systemic fungal infections. It is the gold standard of antifungal therapy. Flucytosine has supraadditive action with amphotericin B if the fungi is sensitive to both. It is also potentiated by rifampicin and minocycline. 

The oral dosage for rapidly excreted tetracyclines, equivalent to tetracycline hydrochloride, is 0.25-0.5 g four times daily for adults and 20-40 mg/kg/d for children (8 years of age and older). For severe systemic infections, the higher dosage is indicated, at least for the first few days. The daily dose is 600 mg for demeclocycline or methacycline, 100 mg once or twice daily for doxycycline, and 100 mg twice daily for minocycline. Doxycycline is the oral tetracycline of choice because it can be given as a once-daily dose and its absorption is not significantly affected by food. All tetracyclines chelate with metals, and none should be orally administered with milk, antacids, or ferrous sulfate. To avoid deposition in growing bones or teeth, tetracyclines should be avoided in pregnant women and children less than 8 years of age. 

Not all mycobacterial infections are caused by M. tuberculosis or M. leprae. These atypical mycobacteria require treatment with secondary medications as well as other chemotherapeutic agents. For example, M. marinum causes skin granulomas, and effective drugs in the treatment of infection are rifampin or minocycline. Mycobacterium fortuitum causes skin ulcers and the medications recommended for treatment are ethambutol, cycloserine, and rifampin in combination with amikacin. 

Si Q, Cosenza M, Kim MO, hao ML, Brownlee M, Goldstein H, Lee S (2004) A novel action of minocycline Inhibition of human immnnodeficiency vims type 1 infection in microglia. J Neurovi-lol 10 284-292. 

Raad I, Hachem R, Hanna H, Girgawy E, Rolston K, Whimbey E, Husni R, Bodey G. Treatment of vancomycin-resistant enterococcal infections in the immunocompromised host quinupristin-dalfopristin in combination with minocycline. Antimicrob Agents Chemother 2001 45(ll) 3202-4. 

Tetracyclines including semi-synthetic derivatives like doxycycline and minocycline are offering a wide range of antimicrobial activity against Gram-positive, Gramnegative bacteria and even some protozoa infections. 

Tetracyclines Tetracycline Doxycycline Minocycline These agents have been effective for initial episodes of urinary tract infections however, resistance develops rapidly, and their use is limited. These agents also lead to candidal overgrowth. They are useful primarily for chlamydial infections. 

Minocycline, a tetracycline, is indicated in syphilis or gonorrhea in patients sensitive to penicillin. In addition, it may be used in uncomplicated urethral, endocervical, or rectal infection, and in uncomplicated gonococcal urethritis in men (see also Figure 96). Tetracyclines enter bacterial cells by both passive diffusion and active transport, and then accumulate intraceUularly. This does not occur in mammalian cells. The tetracyclines bind to the 308 subunit of the bacterial ribosome in such a way that the binding of the aminoacyl-transfer RNA to the acceptor site on the messenger RNA ribosome complex is blocked (see Figure 96). 

Lacassin, E, Schaffo, D., Perronne, C., Longuet, R, Leport, C., and Vilde, J. L. (1995). Clarithromycin-minocycline combination as salvage therapy for toxoplasmosis in patients infected with human immunodeficiency vims. Antimicrob. Agents Chemother. 39, 276-277. 

A combination of rifampin and ethambutol is probably effective minocycline or tetracycline is active in vitro and is used by some physicians. M. scrofulaceum is an uncommon cause of cervical lymphadenitis that is treated with surgical excision. Microbes of the M. fortuitum complex (including Mycobacterium chelonae) may cause chronic lung disease and infections of skin and soft tissues. The microorganisms are highly resistant to most drugs, but amikacin, cefoxitin, and tetracyclines are active in vitro. 

Minocycline has been indicated for the management and treatment of chronic bronchitis and othe upper respiratory tract infections (URTs). Though it essentially possesses comparatively low renal clearance, which is partially compensated for by means of its high serum and tissue levels, it has... 

Tetracycline (Achromycin) Doxycycline (Vibramycin) Demeclocycline (Dedomycin) Minocycline (e.g., Minocin) Inhibits protein synthesis. Binds to 30s subunit blocking amino acid-linked tRNA from binding to the A site of the ribosome. Most Staphylococcus and Streptococcus strains, enterics, mycoplasma, spirochetes, rickettsiae. Not DOC for any microorganism. Used for acne and chlamydial infections in teens. 

Information seems to be limited. There are two isolated eases of increased theophylline levels with minocycline and tetracycline, but controlled studies have not shown any significant changes in overall theophylline pharmacokinetics. It has been suggested that a clinically important interaction may possibly only occur in a few patients. Further study is needed. There seems to be no evidence of adverse interactions with any of the other tetracyclines. However, note that acute infections per se can alter theophylline pharmacokinetics. 

Raad, 1.1., Darouiche, R. O., Dupuis, J., Abi-Said, D., Gabrielli, A., Hachem, R., Wall, M., Harris, R., Jones, J., Buzaid, A., et al., Central venous catheters coated with minocycline and rifampin for the pevention of catheter-related colonization and bloodstream infections. A randomized, double-blind trial. The Texas Medical Center Catheter Study Group, Ann. Intern. Med., 1997 127(4) 267-274. 

Reversible circumscribed cytotoxic edema of the splenium of the corpus callosum has been associated with antiepileptic drugs, arginine-vasopressin, and metronidazole, and with infections with influenza virus and rotavirus. It is completely reversible in most cases. Cytotoxic edema developed in a 15-year-old girl while she was taking minocycline and resolved when stopped taking it [62 ]. 

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