minocycline and Candidiasis

Adequate management of severely ill patients with secondary peritonitis requires supportive therapy of organ dysfunction, source control of infection and antimicrobial therapy. Since secondary peritonitis is polymicrobial, appropriate empiric therapy requires combination therapy in order to achieve the needed coverage for both common and more unusual organisms. This article reviews etiological agents, resistance mechanisms and their prevalence, how and when to cover them and guidelines for treatment in the literature. Local surveillances are the basis for the selection of compounds in antibiotic regimens, which should be further adapted to the increasing number of patients with risk factors for resistance (clinical setting, comorbidities, previous antibiotic treatments, previous colonization, severity…). Inadequate antimicrobial regimens are strongly associated with unfavorable outcomes. Awareness of resistance epidemiology and of clinical consequences of inadequate therapy against resistant bacteria is crucial for clinicians treating secondary peritonitis, with delicate balance between optimization of empirical therapy (improving outcomes) and antimicrobial overuse (increasing resistance emergence).

Topics: Abdominal Cavity; Anti-Bacterial Agents; Candida; Candidiasis; Carbapenems; Critical Illness; Drug Resistance, Multiple, Bacterial; Enterobacteriaceae; Enterobacteriaceae Infections; Fluoroquinolones; Humans; Microbial Sensitivity Tests; Minocycline; Peritonitis; Practice Guidelines as Topic; Risk Factors; Tigecycline

Topics: Amphotericin B; Animals; Antifungal Agents; Aspergillosis; Blastomycosis; Candicidin; Candidiasis; Coccidioidomycosis; Colistin; Cryptococcosis; Dermatomycoses; Drug Resistance, Microbial; Emetine; Flucytosine; Griseofulvin; Histoplasmosis; Humans; Imidazoles; Minocycline; Natamycin; Nystatin; Polyenes; Tolnaftate

Topics: Anti-Bacterial Agents; Biofilms; Candida; Candidiasis; Catheter-Related Infections; Central Venous Catheters; Edetic Acid; Ethanol; Humans; Minocycline; Taurine; Thiadiazines

It is difficult to manage coinfections in critically ill patients, especially in the presence of mixed-species biofilms. The aim of this study was to seek an effective drug combination for managing the dual-species biofilm of Candida albicans and Staphylococcus aureus.. The interaction between fluconazole and minocycline against polymicrobial planktonic cells and polymicrobial biofilms formed over four different time intervals (4 hours, 8 hours, 12 hours, and 24 hours) was investigated using a microdilution checkerboard method. To explore whether the combined effects against the polymicrobial cultures involved calcium regulation, the effects of benidipine and ethylene glycol tetraacetic acid were characterized using a plate streaking method and a liquid-based quantitative method.. Fluconazole combined with minocycline exerted strong effects against polymicrobial planktonic cells and polymicrobial biofilms formed over 4 hours, 8 hours, and 12 hours. The addition of benidipine and ethylene glycol tetraacetic acid enhanced the activity of the drug combination, suggesting that the combined effects may involve the perturbation of calcium homeostasis.. Fluconazole in combination with minocycline is a potential approach for counteracting C. albicans-S. aureus dual-species biofilms.

Topics: Anti-Bacterial Agents; Antifungal Agents; Biofilms; Calcium; Candida albicans; Candidiasis; Coinfection; Drug Interactions; Drug Synergism; Fluconazole; Humans; Microbial Sensitivity Tests; Minocycline; Staphylococcal Infections; Staphylococcus aureus

The use of antibiotic coated catheters has been proposed as a means of reducing catheter related sepsis. In this study, an in vitro comparison of bacterial colonisation rates was made between uncoated umbilical venous catheters and catheters coated with rifampicin and minocycline. The following parameters were determined; the direct antimicrobial effect of coated and uncoated catheter segments against a range of organisms associated with line sepsis, the assessment of the decline in antimicrobial activity in coated catheters immersed in plasma and the inhibitory efficacy of the catheters to colonisation over a 28-day period. Minocycline and rifampicin coated umbilical catheters showed a superior inhibitory effect and prevented colonisation with the commoner line-related organisms, when compared with uncoated catheters. The inhibitory effect declined after 14 days in the human plasma. Resistance to colonisation in vitro may not extend beyond 21 days.

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Bacterial Infections; Candida albicans; Candidiasis; Catheters, Indwelling; Colony Count, Microbial; Drug Combinations; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Minocycline; Rifampin; Time Factors; Umbilical Veins

We investigated the effect of seven antibacterial antibiotics: kanamycin, gentamicin, tetracycline, minocycline, ampicillin, piperacillin and cefotaxime, on survival of mice infected sequentially with a lethal dose of Candida albicans and a sublethal dose of Escherichia coli. The mortality of C. albicans-infected mice was facilitated by the superinfection with E. coli. When administered to mice with C. albicans/E. coli complex infection, aminoglycosides and tetracyclines significantly prolonged the survival period as compared with the infected and untreated controls. The recovery of viable counts of E. coli from the renal tissues was rapidly reduced by the treatment with gentamicin or minocycline, compared to the untreated control. Thus it was concluded that nullification by the treatment with aminoglycosides or tetracyclines of the enhancing effect of E. coli superinfection on the lethality of C. albicans-infected mice is due to early elimination of E. coli from the kidney.

Topics: Ampicillin; Animals; Anti-Bacterial Agents; Candida albicans; Candidiasis; Cefotaxime; Escherichia coli; Escherichia coli Infections; Female; Gentamicins; Kanamycin; Kidney; Mice; Mice, Inbred ICR; Minocycline; Piperacillin; Tetracycline

The in vitro and in vivo activities of catheters coated with minocycline and rifampin and with chlorhexidine gluconate and silver sulfadiazine were evaluated. When incubated in serum at 37 degrees C, the half-life of the inhibitory activity of catheters coated with minocycline and rifampin was 25 days compared with 3 days for catheters coated with chlorhexidine gluconate and silver sulfadiazine. In a rabbit model, catheters coated with minocycline and rifampin were significantly more efficacious than catheters coated with chlorhexidine and silver sulfadiazine in preventing colonization and infection with Staphylococcus aureus (P < .05). Catheters coated with minocycline and rifampin demonstrated broad-spectrum in vitro inhibitory activity against gram-positive bacteria, gram-negative bacteria, and Candida albicans that was significantly superior to the inhibitory activity of catheters coated with chlorhexidine gluconate and silver sulfadiazine (P < .01). Minocycline and rifampin were also highly efficacious in preventing colonization and infection in vivo.

Topics: Animals; Anti-Bacterial Agents; Anti-Infective Agents, Local; Bacterial Adhesion; Bacterial Infections; Candida albicans; Candidiasis; Catheterization, Central Venous; Catheters, Indwelling; Chlorhexidine; Colony Count, Microbial; Drug Combinations; Gram-Negative Bacteria; Gram-Positive Bacteria; Half-Life; Microbial Sensitivity Tests; Minocycline; Rabbits; Rifampin; Silver Sulfadiazine

Topics: Amino Sugars; Anti-Bacterial Agents; Bacteria; Candidiasis; Carbenicillin; Cephalosporins; Cryptococcosis; Drug Synergism; Flucytosine; Glycosides; Gonorrhea; Humans; Meningococcal Infections; Minocycline; Pseudomonas Infections; Spectinomycin; Sulfonamides; Tetracycline; Trimethoprim