minocycline and Chronic-Disease

Eosinophilic pneumonia (EP) is an important subset of patients who present with pulmonary infiltrates and eosinophilia (PIE). EP is classified by chronicity and etiology and drug-induced EP is the main cause of secondary EP. The primary goal of this review was to examine all the case reports published since the syndrome was defined in 1990. It remains unclear whether acute or chronic EP (AEP or CEP) represent different diseases, and the secondary goal of this review is to determine if there are factors that may help distinguish these 2 entities.. PubMed (MEDLINE and Medical Subject Headings) was searched for case reports of drug-induced EP or PIE syndrome published between 1990 and 2017. Case reports were only included if the diagnostic criteria for AEP or CEP were fulfilled. For each case, data were extracted pertaining to age, sex, type of medication associated with the disease, time from the onset of symptoms to diagnosis, eosinophil counts in the blood, eosinophil fractions in bronchoalveolar lavage (BAL) fluid, initial chest radiograph and computed tomography results, use of mechanical ventilation, and use of steroid treatment and recurrence.. We found 196 case reports describing drug-induced EP. The leading cause was daptomycin. From our review, we found that AEP is more common in younger patients with no gender preference. Eosinophilia in the blood at the time of diagnosis characterized only the CEP patients (80% in CEP vs. 20% in AEP). Abnormal findings on radiographic imagine was similar in both syndromes. A significant portion of AEP patients (20%) presented with acute respiratory failure requiring mechanical ventilation. Most patients with EP were treated with steroids with a higher rate of relapse observed in patients with CEP.. AEP is a much more fulminant and severe disease than the gradual onset and slowly progressive nature of CEP. The pathogenesis of AEP and CEP remains unclear. However, there is significant clinical overlap among AEP and CEP that are associated with drug toxicity, suggesting the possibility that AEP and CEP are distinct clinical presentations that share a common pathogenic pathway.

Topics: Acute Disease; Adult; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Chronic Disease; Daptomycin; Eosinophils; Female; Humans; Male; Mesalamine; Middle Aged; Minocycline; Pulmonary Eosinophilia; Sulfasalazine

The vascular events that happen during ischemic stroke worsen outcomes in patients by causing edema, hemorrhagic transformation, and general neurologic tissue compromise. In the past 2 decades, clinical trials in patients after ischemic stroke focused on neuroprotection, but these strategies have failed in providing actual benefit. Vascular protection represents a new field to be explored in acute ischemic stroke in order to develop new approaches to therapeutic intervention.. We identified tactics likely to provide vascular protection in patients with ischemic stroke. These tactics are based on knowledge of the molecular processes involved.. The pathologic processes due to vascular injury after an occlusion of a cerebral artery can be separated into acute (those occurring within hrs), subacute (hrs to days), and chronic (days to mo). Targets for intervention can be identified for all three stages. In the acute phase, superoxide is the predominant mediator, followed by inflammatory mediators and proteases in the subacute phase. In the chronic phase, proapoptotic gene products have been implicated. Many already-marketed therapeutic agents (statins, angiotensin modulators, erythropoietin, minocycline, and thiazolidinediones), with proven safety in patients, have been shown to have activity against some of the key targets of vascular protection.. Currently available pharmacologic agents are poised for clinical trials of vascular protection after acute ischemic stroke.

Topics: Acute Disease; Angiotensin-Converting Enzyme Inhibitors; Brain; Brain Edema; Brain Ischemia; Cerebral Hemorrhage; Chronic Disease; Erythropoietin; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Minocycline; Stroke; Thiazolidinediones; Thrombolytic Therapy

Chronic periodontitis affects many adults in the United States, some severely enough to threaten tooth loss. Of particular clinical importance is whether scaling and root planing (SRP) accompanied by a local adjunctive therapeutic agent improves outcomes over time compared to SRP alone. The adjunctive therapeutic agents investigated include: tetracycline, minocycline, metronidazole, a group of other antibiotics, chlorhexidine, and a group of antimicrobials. Primary outcomes considered are reductions in probing depth (PD) and gains in clinical attachment level (CAL).. RTI-UNC Evidence-Based Practice Center staff searched MEDLINE (1966 through December 2002) and EMBASE (through February 2002) to identify clinical trials published in English that 1) involved adults with chronic periodontitis but no serious comorbidities; 2) tested one or more chemical antimicrobial agents as an adjunct to SRP alone or with a placebo; 3) had a concurrent control group that received the same SRP as the treatment group; 4) reported outcomes for specified, fixed time periods; and 5) if multiple antimicrobials were tested, reported outcomes for each agent separately. We performed qualitative analyses and meta-analyses of PD and CAL effect sizes when the necessary data were available from at least three studies at 6-month follow-up.. Among the locally administered adjunctive antimicrobials, the most positive results occurred for tetracycline, minocycline, metronidazole, and chlorhexidine. Adjunctive local therapy generally reduced PD levels. Differences between treatment and SRP-only groups in the baseline-to-follow-up period typically favored treatment groups but usually only modestly (e.g., from about 0.1 mm to nearly 0.5 mm) even when the differences were statistically significant. Effects for CAL gains were smaller and statistical significance less common. The marginal improvements in PD and CAL were a fraction of the improvement from SRP alone.. Whether such improvements, even if statistically significant, are clinically meaningful remains a question. A substantial agenda of future research to address this and other issues (e.g., costs, patient-oriented outcomes) is suggested.

Topics: Adult; Anti-Bacterial Agents; Anti-Infective Agents, Local; Chemotherapy, Adjuvant; Chlorhexidine; Chronic Disease; Clinical Trials as Topic; Dental Scaling; Humans; Metronidazole; Minocycline; Periodontitis; Tetracycline

Chronic rhinosinusitis encompasses a group of disorders characterized by inflammation of the mucosa of the nose and paranasal sinuses of at least 12 weeks' duration. In addition to nasal obstruction and discharge, chronic sinusitis is a common cause of olfactory dysfunction. Smell loss can result in problems including safety concerns, hygiene matters, appetite disorders, and changes in emotional and sexual behavior. Although smell loss related to sinonasal disease is probably the most treatable form of olfactory dysfunction and treatment can improve olfactory sensation in the setting of sinusitis, most studies show that the effects are usually transient and incomplete.

Topics: Anti-Bacterial Agents; Biopsy; Chronic Disease; Humans; Minocycline; Olfaction Disorders; Olfactory Mucosa; Olfactory Receptor Neurons; Sinusitis

Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Chronic Disease; Contraindications; Drug Delivery Systems; Humans; Microspheres; Minocycline; Periodontitis

Topics: Adult; Anti-Bacterial Agents; Chronic Disease; Female; Humans; Minocycline; Rosacea; Syndrome; Thyroid Diseases; Thyroid Gland

Periodontitis is a bacterial infection. It appears in a generalised form but more often appears in local areas in a patient's mouth or is reduced to localised areas by mechanical treatment. Periodontitis lends itself well to treatment by means of a controlled local delivery system using an antimicrobial agent. Several products have been introduced or are in the process of clearing regulatory agencies. It is the goal of all local delivery systems to deliver high concentrations of an antimicrobial directly to the site of the periodontal infection. Concentrations of medication can be achieved considerably higher than could be obtained with systemic administration, while the systemic uptake of the medication is minimal. Five local delivery systems (tetracycline fibre, doxycycline polymer, chlorhexidine chip, minocycline ointment and metronidazole gel) are now available. Techniques for their use and the supporting scientific evidence are presented and indications for the use of the various systems are also discussed. These local delivery systems offer the clinician additional therapeutic procedures to aid in the treatment of the chronic inflammatory periodontal diseases.

Topics: Administration, Topical; Anti-Bacterial Agents; Anti-Infective Agents; Anti-Infective Agents, Local; Chlorhexidine; Chronic Disease; Doxycycline; Drug Delivery Systems; Drug Implants; Gels; Humans; Metronidazole; Minocycline; Ointments; Periodontitis; Polymers; Tetracycline

Tetracyclines are frequently used in the treatment of periodontitis; however, emergence of resistant bacterial strains has decreased the utility of these drugs. At present, there are a lot of data in the literature from which one can draw conclusions regarding the use of local drug delivery. This paper reviews the utility and different systems of local delivery of minocycline, a semisynthetic tetracycline, in the treatment of periodontitis.

Topics: Administration, Topical; Anti-Bacterial Agents; Chronic Disease; Contraindications; Humans; Microspheres; Minocycline; Ointments; Periodontitis

Topics: Adult; Animals; Anti-Bacterial Agents; Chronic Disease; Drug Evaluation; Drug Evaluation, Preclinical; Humans; Minocycline; Periodontitis; Tetracyclines

The aim of this study was to compare the efficacy and safety of ilaprazole and esomeprazole both in initial treatment regimen and retreatment regimen of H. pylori infection in chronic gastritis and to explore risk factors for eradication failure. A total of 330 patients with chronic gastritis who were confirmed of H. pylori infection were enrolled in this study. 290 of them were initially treated patients and the 40 remained were patients with retreatment. Eradication assessment was performed at least four weeks after the completion of eradication therapy. Results showed that the eradication rates of the ilaprazole group and esomeprazole group were 91.4 % and 88.4 % for per-protocol (PP) analysis (p=0.41) and 89.0 % and 86.2 % for intention-to-treat (ITT) analysis (p=0.48) in initially treated patients. Meanwhile, they were 75.0 % and 72.2 % for PP analysis (p=0.85) and 75.0 % and 70.0 % for ITT analysis (p=0.72) in patients with retreatment. The differences were not statistically significant. There was also no significant difference in safety between the two drugs. A multiple logistic regression analysis showed that demographic factors such as age, gender, alcohol, smoking, coronary heart disease (CHD), hypertension (HTN) and diabetes mellitus (DM) did not affect eradication rates. However, patients with higher DOB values and patients with atrophic gastritis had significantly lower eradication rates than patients with lower DOB values and with non-atrophic gastritis whether the proton pump inhibitor (PPI) in eradication regimens was ilaprazole or esomeprazole. In conclusion, our findings suggest that the efficacy and safety of ilaprazole and esomeprazole were not significantly different both in initial treatment regimen and retreatment regimen of H. pylori infection in chronic gastritis and DOB values and type of chronic gastritis were to be independent risk factors for eradication failure. In addition, we discovered that a new quadruple regimen containing furazolidone and minocycline which achieved good efficacy and safety can be a promising option for retreatment of H. pylori infection.

Topics: 2-Pyridinylmethylsulfinylbenzimidazoles; Adult; Anti-Bacterial Agents; Chronic Disease; Drug Therapy, Combination; Esomeprazole; Female; Furazolidone; Gastritis; Gastritis, Atrophic; Helicobacter Infections; Helicobacter pylori; Humans; Male; Middle Aged; Minocycline; Prospective Studies; Proton Pump Inhibitors; Retreatment; Treatment Failure; Treatment Outcome

The aim of the study was to evaluate the effects of minocycline microspheres on periodontal probing depth reduction when used in combination with surgery in adults with moderate to severe, chronic periodontitis.. Sixty patients with a minimum of one non-molar periodontal site > or =6 mm in two oral quadrants received either local minocycline microspheres at baseline, immediately following each of two surgical therapies (Weeks 2 and 3), and at Week 5 or surgery alone.. The mean probing depth reduction at Week 25 at sites > or =5 mm at baseline was 2.51 mm in the test group and 2.18 mm in the control group. Smokers in the test group had a significantly greater probing depth reduction (2.30 mm) than smokers in the control group (2.05 mm). The number of sites with probing depth reductions of > or =2 and > or =3 mm were significantly higher in the test group than in the control group.. Applications of local minocycline as an adjunct to surgery in adults with moderate to severe, chronic periodontitis were associated with statistically significant greater reductions in probing depth than surgery alone.

Topics: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Chemotherapy, Adjuvant; Chronic Disease; Female; Humans; Male; Microspheres; Middle Aged; Minocycline; Oral Surgical Procedures; Periodontal Index; Periodontitis; Single-Blind Method; Smoking; Statistics, Nonparametric; Surgical Flaps; Treatment Outcome

The clinical benefits of minocycline in combination with thorough scaling and root planing (SRP) have been examined in multicenter studies. The aim of this longitudinal investigation was to evaluate the clinical response to scaling and root planing combined with the use of locally delivered minocycline microspheres for 720 days in individuals with advanced chronic periodontitis.. A total of 26 individuals aged 26 to 69 years (mean: 46.8+/-12.1 years) were included in this double-blind randomized clinical trial. After randomization, 13 individuals were selected for the test group (TG) and treated with SRP plus subgingival minocycline at baseline and 90, 180, and 270 days, and 13 individuals were selected for the control group (CG) and received SRP plus vehicle at the same timepoints. Two homologous sites with probing depth (PD)>or=6 mm were chosen in each subject. To evaluate the clinical response after treatment, PD, plaque index (PI), and gingival index (GI) were assessed at baseline and 90, 180, 270, 360, and 720 days.. No statistical differences were found between test and control groups in relation to PD at the different timepoints. The mean values of PD demonstrated a higher reduction in the test group at 270 and 360 days. No statistical differences were observed at 90, 180, and 720 days between TG and CG (P<0.05; Wilcoxon test). There were no statistically significant differences between TG and CG concerning PI and GI (P<0.05; analysis of variance and t test) at all evaluated timepoints.. Our findings demonstrated that both therapies reduced mean PD from 90 to 360 days; however, SRP combined with the use of subgingival minocycline showed a higher reduction at 270 and 360 days following therapy.

Topics: Adult; Aged; Anti-Bacterial Agents; Chronic Disease; Combined Modality Therapy; Dental Plaque Index; Dental Scaling; Double-Blind Method; Female; Follow-Up Studies; Humans; Longitudinal Studies; Male; Microspheres; Middle Aged; Minocycline; Periodontal Index; Periodontal Pocket; Periodontitis; Placebos; Root Planing

The use of adjunctive minocycline with mechanical debridement in treating periodontitis has been widely studied using different methods. However, the results from these studies are equivocal.. The purpose of this study was to clarify the efficacy of the adjunctive use of subgingival minocycline application plus scaling/root planing as compared with the results of one episode of scaling/root planing in the treatment of chronic periodontitis.. Fifteen patients were enrolled in this split-mouth clinical trial. Probing depth, clinical attachment loss, gingival index, and bleeding on probing were evaluated at the baseline before scaling/root planing and 6, 10, 14, and 18 weeks later according to a single-blind protocol. The amount of interleukin-1beta (interleukin-1beta pg/site) at each lesion was also simultaneously measured in gingival crevicular fluid in a parallel comparison design. After full-mouth baseline measurements and scaling/root planing, 78 lesions with a residual mean probing depth of 5 mm at anterior teeth were selected and equally distributed in either right or left sites based on a split-mouth symmetrical design and randomly assigned to one of two treatment groups (with or without minocycline administration, n = 39 for each group).. Probing depth significantly decreased from the baseline (week 0) to week 6 after scaling/root planing (p < 0.05) in both groups, but there was no statistically significant difference between the two groups (p > 0.05). However, at weeks 10, 14, and 18, the experimental group showed significantly greater improvement in pocket reduction than the control group (p < 0.05). Similarly, both groups also showed significant decreases in gingival index scores from weeks 0-6 (p < 0.05), but gingival index reductions at weeks 10, 14, and 18 were statistically significant in favor of the experimental group (p < 0.05). The experimental group had more attachment gain than the control group at weeks 14 and 18 (p < 0.05). Values of interleukin-1beta (pg/site) at the experimental sites were significantly reduced at weeks 10, 14, and 18, as compared to values at control sites (p < 0.01). Finally, the incidence of bleeding on probing showed no differences between the two groups for any time interval (p > 0.05).. In this 18-week clinical trial, the results suggested that scaling/root planing with adjunctive subgingival administration of minocycline ointment has a significantly better and prolonged effect compared to scaling/root planing alone on the reduction of probing depth, clinical attachment loss, gingival index, and interleukin-1beta content, but not on bleeding on probing.

Topics: Adult; Anti-Bacterial Agents; Chronic Disease; Dental Scaling; Female; Humans; Interleukin-1; Male; Middle Aged; Minocycline; Periodontitis; Root Planing; Single-Blind Method; Statistics, Nonparametric

A recent Phase 3 trial demonstrated that adjunctive treatment with minocycline microspheres resulted in significant reductions in patient mean probing depths as compared to scaling and root planing (SRP) alone. The objective of the present study was to evaluate clinical relevance of these changes within the trial using proposed site-based criteria.. A total of 499 patients with moderate to advanced chronic periodontitis were enrolled in a multi-center trial and randomized to either: 1) SRP alone or 2) SRP plus minocycline microspheres. Subjects received complete probing examinations including the measurement of probing depths at baseline, and 1 and 3 months. Probing depth reductions were tabulated by treatment, examination time, and baseline depths, and inter-group differences were evaluated with logistic regression models for correlated data.. Significantly more sites treated with adjunctive minocycline microspheres exhibited probing depths < 5 mm at 1 (P = 0.0009) and 3 (P = 0.01) months as compared to sites treated with SRP alone, both in the overall population and in smokers. In addition, significantly more sites decreased by 1, 2, or 3 mm in the adjunctive minocycline group than in the SRP alone group at 1 and 3 months, both overall as well as in smokers (P < 0.05).. This secondary analysis indicates that treatment with SRP plus minocycline microspheres is consistently more effective than SRP alone in providing clinically relevant site-based responses in patients with chronic periodontitis.

Topics: Anti-Bacterial Agents; Chronic Disease; Dental Scaling; Female; Humans; Logistic Models; Male; Microspheres; Middle Aged; Minocycline; Periodontitis; Smoking; Treatment Outcome

This article presents the results of a single-arm, open-label, multicenter clinical trial of the topical use of sustained-release minocycline hydrochloride (HCl) microspheres as an adjunct to scaling and root planing. The objective of this study was to evaluate the long-term safety and efficacy of the subgingival application of resorbable minocycline microspheres as an adjunct to scaling and root planing in the treatment of chronic periodontitis. The primary outcome measures were the reduction in probing pocket depth at 9- and 12-month evaluations, and the percent of bleeding upon probing. A total of 173 patients with moderate-to-severe chronic periodontitis were enrolled in this multicenter clinical trial. All patients received full-mouth scaling and root planing plus minocycline microspheres in all periodontal pockets that probed > or = 5 mm. All sites treated at baseline and any new sites > or = 5 mm again received minocycline microspheres at 3- and 6-month follow-up appointments with no further scaling and root planing. Significant improvements in all clinical parameters measured were found at all time points (1, 3, 6, 9 and 12 months). The product was found to be well-tolerated by patients, safe, and easy to deliver. Scaling and root planing with the topical application of minocycline microspheres appeared to give better results than would have been expected with scaling and root planing alone.

Topics: Absorbable Implants; Adult; Anti-Bacterial Agents; Chronic Disease; Combined Modality Therapy; Delayed-Action Preparations; Dental Scaling; Female; Follow-Up Studies; Gingival Hemorrhage; Humans; Male; Microspheres; Minocycline; Periodontal Attachment Loss; Periodontal Pocket; Periodontitis; Root Planing; Safety; Statistics, Nonparametric; Treatment Outcome

Gingival crevicular fluid (GCF) biomarkers associated with bone resorption may be useful to determine periodontal disease status and response to therapy. The pyridinoline cross-linked carboxy-terminal telopeptide of type I collagen (ICTP), a bone-specific degradation product, and interleukin 1-beta (IL-1), a potent bone-resorptive cytokine, have both been associated with periodontal disease activity. Minocycline is a tetracycline derivative possessing antimicrobial effects on periodontal pathogens and inhibitory properties on matrix metalloproteinases (MMPs) associated with tissue destruction. The aim of this study was to evaluate the effect of periodontal treatment in the form of scaling and root planing (SRP) and locally administered minocycline microspheres on the GCF levels of ICTP and IL-1.. Forty-eight chronic periodontitis patients were randomly assigned to 2 groups (SRP plus subgingival application of vehicle control [SRP + V], or SRP plus subgingival application of minocycline microspheres [SRP + M]) and monitored at 8 sites per subject at baseline and 1, 3, and 6 months. Four shallow (PD < or = 3 mm) and 4 deep (PD > or = 5 mm) sites were evaluated for both marker levels and for probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP). Eight periodontally healthy control subjects with no probing depths >3 mm and no loss of attachment were also monitored at the same time intervals. GCF levels of ICTP and IL-1 were determined using radioimmunoassay and enzyme-linked immunosorbent assay techniques, respectively.. Significant differences (P<0.001) in GCF levels of ICTP and IL-1 were found between deep and shallow sites at all time points in both treatment groups. In addition, healthy subjects demonstrated significantly reduced levels of both markers compared to both shallow and deep sites in periodontitis patients (P <0.001). Only the SRP + M treated patients exhibited significant reductions (P <0.05) in both ICTP and IL-1 levels 1 month after treatment. Furthermore, the SRP + M group demonstrated significantly lower IL-1 levels (P <0.02) at 1 month compared to the SRP + V group.. Results of this study indicate that GCF levels of ICTP and IL-1 correlate with clinical measures of periodontal disease and may aid in assessing disease status and response to periodontal therapy. Furthermore, local administration of minocycline microspheres led to a potent short-term reduction in GCF IL-1 levels. Additional studies are needed to address whether repeated administration of scaling and root planing along with minocycline microspheres will achieve long-term reductions in GCF ICTP and IL-1 levels.

Topics: Administration, Topical; Adult; Aged; Analysis of Variance; Anti-Bacterial Agents; Biomarkers; Bone Resorption; Chronic Disease; Collagen; Collagen Type I; Dental Scaling; Female; Follow-Up Studies; Gingival Crevicular Fluid; Gingival Hemorrhage; Humans; Interleukin-1; Male; Matched-Pair Analysis; Microspheres; Middle Aged; Minocycline; Peptides; Periodontal Attachment Loss; Periodontal Pocket; Periodontitis; Root Planing; Single-Blind Method; Statistics as Topic

Locally delivered antimicrobials represent an expanding class of therapeutics that may complement conventional mechanical treatments for chronic periodontitis. Currently available locally delivered antimicrobials include a tetracycline fiber, chlorhexidine chip, doxycycline gel, and newly approved minocycline microspheres. This last therapeutic is formulated to contain 3 mg polyglycolide-co-dl lactide (PGLA) copolymer and 1 mg of minocycline per unit (pocket) dose. As the polymer microspheres resorb, minocycline is released locally within the periodontal pocket at effective concentrations for at least 14 days. Recently, three phase 3 human clinical trials were conducted to assess the efficacy and safety of minocycline microspheres in patients with moderate-to-advanced chronic periodontitis. Data from an open-label trial involving 173 subjects indicated that minocycline microspheres plus scaling and root planing (SRP) at baseline produced significant improvements in pocket depth (PD) (> or = 1.5 mm) at 1 and 3 months. Retreatment with minocycline microspheres at 3 and 6 months maintained these improvements for 12 months. Two concurrent, blinded studies cumulatively recruited 748 periodontitis subjects who were randomized to SRP plus minocycline microspheres, SRP plus vehicle (placebo), or SRP alone at baseline. Minocycline microspheres or the vehicle were readministered per the randomization at 3 and 6 months. Patients receiving minocycline microspheres plus SRP exhibited significantly greater PD reduction at 1, 3, 6, and 9 months compared to patients receiving SRP plus vehicle or SRP alone. Overall, mean PD reduction with adjunctive minocycline-microsphere treatment increased when patients with more advanced periodontitis (mean PD > or = 6 mm or 7 mm) were considered. Similarly, significant improvements in clinical attachment level and percent bleeding on probing were observed among advanced periodontitis patients treated with SRP plus minocycline microspheres relative to controls. Patients treated with minocycline microspheres plus SRP were 50% more likely to shift to an overall mean PD < 5 mm or to a more maintainable case definition. No increased incidence of adverse events or tetracycline resistance were observed with minocycline-microsphere treatment. The data from these clinical trials indicate that minocycline microspheres plus SRP are safe in patients and more effective than SRP alone in reducting the signs of chronic periodontitis.

Topics: Analysis of Variance; Anti-Bacterial Agents; Chronic Disease; Delayed-Action Preparations; Dental Scaling; Drug Carriers; Female; Follow-Up Studies; Gingival Hemorrhage; Humans; Lactic Acid; Male; Microspheres; Middle Aged; Minocycline; Periodontal Attachment Loss; Periodontal Pocket; Periodontitis; Placebos; Polyglycolic Acid; Polylactic Acid-Polyglycolic Acid Copolymer; Polymers; Root Planing; Safety; Single-Blind Method; Treatment Outcome

Alternative regimens using subgingival antimicrobials compared to conventional periodontal maintenance (PM) may lead to more efficient protocols. The purpose of this study was to evaluate treatment time and clinical and radiographic outcomes in 2 periodontitis cohorts, one receiving conventional PM and the other receiving scaling and root planing (SRP) and multiple doses of subgingival minocycline.. Moderate to advanced chronic periodontitis patients were concurrently treated with either: 1) scaling and root planing and 4 subgingival doses of minocycline microspheres in all > or = 5 mm pockets over a 6-month period (RP/M; n = 24 patients); or 2) conventional 3-month periodontal maintenance (PM; n = 24 patients). Clinical and radiographic measurements, including probing depth (PD), clinical attachment level (CAL), and interproximal bone height (BH), were analyzed in 2 premolar/molar interproximal > or = 5 mm pockets at baseline and 1 year using paired t tests, analysis of variance, chi-square analysis, and correlation coefficients.. Baseline clinical and radiographic data were similar between RP/M and PM patients. Probing depths showed greater mean improvement in RP/M (0.9 +/- 0.1 versus 0.4 +/- 0.1 mm, P = 0.02), with 25% of subjects in RP/M gaining > or = 2 mm compared to 4.2% in PM (differences were statistically significant). The mean loss in bone height and percent subjects losing bone height were less in RP/M (0.05 +/- 0.05 mm; 12.5%) than PM (0.09 +/- 0.08 mm; 16.7%), but bone height differences were not statistically significant. A subset of RP/M molar furcation sites responded with similar PD reduction and no BH loss over 1 year. While cross-sectional RP/M data between CAL and BH, or PD and CAL were highly correlated, changes over 1 year were not correlated among any of these parameters.. Scaling and root planing and subgingival minocycline in experimental sites took little time (<5 minutes/appointment), but resulted in more probing depth reduction and less frequent bone height loss than conventional periodontal maintenance.

Topics: Administration, Topical; Alveolar Bone Loss; Analysis of Variance; Anti-Bacterial Agents; Bicuspid; Case-Control Studies; Chi-Square Distribution; Chronic Disease; Cohort Studies; Dental Scaling; Female; Follow-Up Studies; Gingiva; Humans; Male; Matched-Pair Analysis; Middle Aged; Minocycline; Molar; Periodontal Attachment Loss; Periodontal Pocket; Periodontitis; Radiography; Root Planing; Statistics as Topic; Treatment Outcome

Currently, several local antimicrobial delivery systems are available to periodontists. The aim of this 6-month follow-up parallel study was to evaluate the efficacy of three commercially available local delivery systems as adjuncts to scaling and root planing in the treatment of sites with persistent periodontal lesions.. Seventy-nine patients with 4 pockets > or = 5 mm and bleeding on probing and/or suppuration were randomized into 4 treatment groups which included: scaling and root planing alone (S) (20 patients), or in conjunction with the application of 25% tetracycline fibers (S+Tet) (19 patients), or 2% minocycline gel (S+Min) (21 patients), or 25% metronidazole gel (S+Met) (19 patients). Clinical measurements were taken at baseline, 6 weeks, 3 months, and 6 months after antimicrobial application. Treatments were applied using the distributors' recommended protocols.. All 4 therapies resulted in significant improvements from baseline in probing depth, attachment level, bleeding on probing, and the Modified Gingival Index (MGI) scores. The improvements in clinical parameters were greater in all 3 adjunctive treatment groups than scaling and root planing alone. The mean probing depth reductions at 6 months were: scaling + tetracycline = 1.38 mm; scaling + metronidazole = 0.93 mm; scaling + minocycline = 1.10 mm; and scaling alone = 0.71 mm. The probing depth reduction at all time points was significantly greater in the scaling plus tetracycline fiber group than the scaling and root planing alone group (P<0.01). There was also a significant improvement for scaling plus tetracycline fiber application over scaling and metronidazole at both 6 weeks and 3 months, although this did not remain significant at the 6-month visit. While the frequency of sites with suppuration was markedly reduced following all antimicrobial treatments, the most effective reductions were seen in the scaling plus tetracycline fiber group, followed by the minocycline group.. Although all 3 locally applied antimicrobial systems seem to offer some benefit over scaling and root planing alone, a treatment regimen of scaling and root planing plus tetracycline fiber placement gave the greatest reduction in probing depth over the 6 months after treatment.

Topics: Adult; Analysis of Variance; Anti-Bacterial Agents; Anti-Infective Agents, Local; Chronic Disease; Dental Scaling; Drug Delivery Systems; Female; Follow-Up Studies; Gels; Humans; Linear Models; Male; Metronidazole; Middle Aged; Minocycline; Periodontal Index; Periodontal Pocket; Statistics, Nonparametric; Tetracycline; Treatment Outcome

A double-blind, randomized, parallel, comparative study was designed to evaluate the long-term safety and efficacy of subgingivally administered minocycline ointment versus a vehicle control.. One hundred four patients (104) with moderate to severe adult periodontitis (34 to 64 years of age; mean 46 years) were enrolled in the study. Following scaling and root planing, patients were randomized to receive either 2% minocycline ointment or a matched vehicle control. Study medication was administered directly into the periodontal pocket with a specially designed, graduated, disposable applicator at baseline; week 2; and at months 1, 3, 6, 9, and 12. Scaling and root planing was repeated at months 6 and 12. Standard clinical variables (including probing depth and attachment level) were evaluated at baseline and at months 1, 3, 6, 9, 12, and 15. Microbiological sampling using DNA probes was done at baseline; at week 2; and at months 1, 3, 6, 9, 12, and 15.. Both treatment groups showed significant and clinically relevant reductions in the numbers of each of the 7 microorganisms measured during the entire 15-month study period. When differences were detected, sites treated with minocycline ointment always produced statistically significantly greater reductions than sites which received the vehicle control. For initial pockets > or =5 mm, a mean reduction in probing depth of 1.9 mm was seen in the test sites, versus 1.2 mm in the control sites. Sites with a baseline probing depth > or =7 mm and bleeding index >2 showed an average of 2.5 mm reduction with minocycline versus 1.5 mm with the vehicle. Gains in attachment (0.9 mm and 1.1 mm) were observed in minocycline-treated sites, with baseline probing depth > or =5 mm and > or =7 mm, respectively, compared with 0.5 mm and 0.7 mm gain at control sites. Subgingival administration of minocycline ointment was well tolerated.. Overall, the results demonstrate that repeated subgingival administration of minocycline ointment in the treatment of adult periodontitis is safe and leads to significant adjunctive improvement after subgingival instrumentation in both clinical and microbiologic variables over a 15-month period.

Topics: Adult; Aggregatibacter actinomycetemcomitans; Analysis of Variance; Anti-Bacterial Agents; Campylobacter; Canada; Chronic Disease; Colony Count, Microbial; Dental Plaque Index; Dental Scaling; Double-Blind Method; Eikenella corrodens; Europe; Female; Fusobacterium nucleatum; Humans; Longitudinal Studies; Male; Middle Aged; Minocycline; Ointments; Periodontal Index; Periodontal Pocket; Periodontitis; Porphyromonas gingivalis; Prevotella intermedia; Statistics, Nonparametric; Treatment Outcome; Treponema

A study was conducted to assess the clinical and microbiological effects of antimicrobial treatment for chronic prostatitis as a means of defining the role of Ureaplasma urealyticum. Significant U. urealyticum cells were considered to be isolated from the prostates of 18 of 143 prostatitis patients. These patients with ureaplasma-associated prostatitis were randomly treated with either ofloxacin or minocycline for 2 weeks; 4 patients were excluded due to voluntary withdrawal. U. urealyticum was eradicated in all the patients. Symptoms were resolved in 10 patients, and leukocytes in expressed prostatic secretion were cleared in 4 patients; both drug treatments revealed similar results. Even if we exclude 3 patients with significant coexistent Staphylococcus epidermidis cells before treatment, 3 of 11 patients evaluated showed complete resolution of symptoms and clearance of leukocytes in expressed prostatic fluid. These results suggest that U. urealyticum is a causative organism in some patients with chronic prostatitis.

Topics: Adult; Aged; Chronic Disease; Humans; Leukocyte Count; Male; Middle Aged; Minocycline; Ofloxacin; Prostatitis; Ureaplasma Infections; Ureaplasma urealyticum

The safety and efficacy of subgingivally-applied 2% minocycline ointment was evaluated in a randomized, double-blind study of 103 adults with moderate to severe periodontitis. Two groups were compared; one received the test minocycline ointment and the other a vehicle control. Both groups had scaling and root planing at baseline, after which the test or control ointments were applied with an applicator into the periodontal pockets at baseline, and at 2, 4, and 6 weeks. Assessment of clinical response was made by measuring probing depth and probing attachment level and gingival bleeding. These measurements were made at baseline prior to scaling and root planing, and at weeks 4 and 12. Microbiological assessment of the subgingival flora was carried out with DNA probes at baseline, and at weeks 2, 4, 6, and 12 to identify and quantify Porphyromonas gingivalis, Prevotella intermedia, and Actinobacillus actinomycetemcomitans. Subgingival minocycline ointment resulted in statistically significantly greater reduction of P. gingivalis at weeks 2, 4, 6, and 12; P. intermedia at weeks 2, 4, 6, and 12; and A. actinomycetemcomitans at weeks 6 and 12. Probing depth reductions were seen for both groups at weeks 4 and 12; however, this reduction was statistically significantly greater in subjects treated with minocycline ointment. Reduction in gingival index and probing attachment gain were seen in both groups, however, the differences between the groups were not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Administration, Topical; Adult; Aged; Aggregatibacter actinomycetemcomitans; Bacteroides; Belgium; Chronic Disease; Colony Count, Microbial; Dental Plaque Index; DNA Probes; Double-Blind Method; Female; Humans; Male; Middle Aged; Minocycline; Ointments; Periodontal Index; Periodontal Pocket; Periodontitis; Porphyromonas gingivalis; Treatment Outcome

A group of 41 patients, all admitted to hospital because of acute purulent exacerbations of chronic respiratory disease, were treated with either doxycycline or minocycline in a double-blind randomized study. Drug dosage was one 100 mg capsule twice daily for seven days. Bacteriological and clinical assessment before and immediately after treatment showed no significant differences between the doxycycline and the minocycline groups, nor did further evaluation after seven days follow-up. Pharmacokinetic studies showed that the Cmax and 0-11 h AUC values in blood were higher for doxycycline, whereas the sputum Cmax was, on average, higher for minocycline because of the greater penetration of the latter. The MIC values for the two antibiotics differed slightly, usually, but not always, in favour of minocycline. Problems were experienced with both agents in the eradication of Haemophilus influenzae. The net clinical results with the two drugs were identical.

Topics: Adult; Bacterial Infections; Bronchitis; Chronic Disease; Clinical Trials as Topic; Double-Blind Method; Doxycycline; Female; Haemophilus Infections; Haemophilus influenzae; Humans; Male; Microbial Sensitivity Tests; Minocycline; Moraxella catarrhalis; Pneumococcal Infections; Random Allocation; Streptococcus pneumoniae; Tetracyclines

Topics: Acute Disease; Adolescent; Adult; Chronic Disease; Clinical Trials as Topic; Cystitis; Female; Humans; Male; Middle Aged; Minocycline; Pyelitis; Sulfamethoxazole; Tetracyclines; Trimethoprim; Urinary Tract Infections

Topics: Bronchitis; Chronic Disease; Clinical Trials as Topic; Diarrhea; Escherichia coli; Female; Gastrointestinal Diseases; Haemophilus influenzae; Humans; Male; Minocycline; Staphylococcus; Streptococcus; Suppuration; Tetracycline; Tetracyclines

Topics: Acetaldehyde Dehydrogenase Inhibitors; Acidosis; Anti-Bacterial Agents; Brain; Chronic Disease; Clinical Deterioration; Consciousness Disorders; Diagnostic Errors; Disulfiram; Electroencephalography; Fatal Outcome; Humans; Inappropriate Prescribing; Lyme Disease; Magnetic Resonance Imaging; Male; Middle Aged; Minocycline; Patient Care; Respiration, Artificial; Seizures; Tinidazole

To investigate the clinical value of the prostate small extracorporeal protein (PSEP) level in the urine in evaluating the therapeutic effect on chronic prostatitis (CP).. Totally 188 CP patients were treated with minocycline and Ningmitai Capsules in our hospital and regularly returned for follow-up examination from November 2017 to November 2018. Based on the results of treatment after 4 and 8 weeks of medication, we divided the patients into a cured, an effective and an ineffective group and compared the contents of PSEP in the urine samples of the three groups of patients before and after treatment.. Compared with the baseline, the PSEP content in the urine after 4 weeks of medication was decreased in the cured group (n = 20) (［3.63 ± 3.81］ vs ［1.16 ± 0.41］ ng/ml, P < 0.05), effective group (n = 85) (［4.13 ± 4.05］ vs ［2.97 ± 2.89］ ng/ml, P > 0.05) and ineffective group (n = 83) (［4.72 ± 2.98］ vs ［3.74 ± 1.31］ ng/ml, P > 0.05), and so was that after 8 weeks of treatment in the cured group (n = 48) (［3.72 ± 3.51］ vs ［0.89 ± 0.37］ ng/ml, P < 0.05), effective group (n = 106) (［4.37 ± 3.93］ vs ［1.83 ± 0.71］ ng/ml, P < 0.05) and ineffective group (n = 34) (［4.61 ± 3.59］ vs ［3.58 ± 1.15］ ng/ml, P > 0.05).. The PSEP level in the urine can be used as an index for clinical evaluation of the therapeutic effect on chronic prostatitis.

Topics: Chronic Disease; Drugs, Chinese Herbal; Humans; Male; Minocycline; Prostatitis; Proteins; Urinalysis

Topics: Acantholysis; Aged; Biopsy, Needle; Chronic Disease; Dose-Response Relationship, Drug; Drug Administration Schedule; Enzyme-Linked Immunosorbent Assay; Female; Fluorescent Antibody Technique, Direct; Follow-Up Studies; Humans; Ichthyosis; Immunohistochemistry; Japan; Leukocyte Count; Minocycline; Neutrophils; Treatment Outcome

Despite decades of research, the fundamental neurochemical and molecular mechanisms underlying the major depressive disorder (MDD) are still poorly understood, and current antidepressant treatments have limited clinical efficacy. In clinical conditions, the rapprochement between the disease and the corrective actions of drugs in laboratory animals is essential for developing effective therapies. Thus, the aim of this study was to evaluate the antidepressant effects of ketamine (N-metil-d-asparte (NMDA) receptor antagonist), minocycline (tetracycline antibiotic), and amitriptyline (classical antidepressant), on behavior and oxidative stress parameters in animals submitted to the chronic mild stress (CMS) and maternal deprivation protocols. For this aim, male Wistar rats were submitted to maternal deprivation or CMS. To induce maternal deprivation, Wistar rats were deprived of maternal care during the first 10 days of life. To induce CMS, Wistar rats were submitted to the CMS for 40 days. To reverse the effects of stress, treatment was done intraperitoneally with a single dose of ketamine (15 mg/kg), and minocycline (25 mg/kg) and amitriptyline (10 mg/kg) by 20 days. After treatment, the animals were submitted to the forced swimming test and then analyzed oxidative stress parameters in the prefrontal cortex (PFC), hippocampus, amygdala and nucleus accumbens (NAc). Treatment with ketamine, minocycline and amitriptyline were able to exert antidepressant effects in the forced swimming test. However, these antidepressant effects were dependent on the stress model by which the animals were exposed. In certain brain regions some treatment strategies had a pro-oxidant effect. Though, most of the strategies used in this study had antioxidant effects, as reported by a decrease on protein and lipid damage, nitrite/nitrate concentration and myeloperoxidase activity. In addition, an increase in the antioxidant superoxide dismutase (SOD) and catalase (CAT) enzymes activities were also evident after treatments. In conclusion, the antidepressant effects of ketamine and minocycline, in the present study, may be associated, at least in part, with its antioxidant and neuroprotective effects in animals subjected to maternal deprivation or CMS.

Topics: Amitriptyline; Animals; Antidepressive Agents; Antioxidants; Brain; Chronic Disease; Depressive Disorder, Major; Disease Models, Animal; Drug Administration Schedule; Drug Therapy, Combination; Ketamine; Male; Maternal Deprivation; Minocycline; Oxidative Stress; Rats, Wistar; Stress, Psychological

Pain is a sensory experience of a complex physiological nature in which is not only involved the nervous system. Among its many features is the development of chronic pain that is more complicated to treat because of the central somatization processes involved, becoming inefficient treatments used in other forms of pain. Among them is the role of glial cells, whose participation is such that some authors have proposed to chronic pain as a gliopathy. Because of this, the drug target of possible treatments focuses on modulating nociceptive response affecting transduction into the central nervous system through affecting synapses in the dorsal horn of the spinal cord. Solid lipid nanoparticles enter the central nervous system, protecting the drug, and in addition to the advantage of having greater absorption surface, all factors that improve drug activity. This work is based on the development and characterization of lipid nanoparticles of solid phase incorporating two antibiotics, minocycline, and ciprofloxacin with antinociceptive properties and challenged them with a rat monoarthritis model using Sprague-Dawley adult male rats. The solid lipid nanoparticles were prepared to modify the lipid, and surfactant amounts to obtain the best encapsulation capacity of the antibiotics, size and z potential. By using the Randall-Selitto test, we measured its pharmacological efficiency as an anti-inflammatory and measuring the time span the antibiotics are active. The encapsulated antibiotics were at least 50% more efficient than the antibiotic alone, and that is possible to measure anti-inflammatory activity up to seven days after the antibiotic application. The former is important for example, in the veterinary field, since a single application of the antibiotic will be necessary for the complete treatment, avoiding excessive stress for the animals. We can conclude that antinociceptive antibiotics encapsulation is a very effective, environmentally safe and inexpensive method for improving the pharmacological efficiency and time span the antibiotics are acting. Since these antibiotics are both anti-microbial and antinociceptive, his use in the field of veterinary presents the advantage of being adequate in single doses, with the saving of time and stress to the animals under treatment.

Topics: Analgesics; Animals; Anti-Bacterial Agents; Arthritis; Chronic Disease; Ciprofloxacin; Delayed-Action Preparations; Drug Carriers; Drug Liberation; Lipids; Male; Minocycline; Nanoparticles; Rats; Rats, Sprague-Dawley

The incidence of sudden unexpected death in epilepsy (SUDEP) is highest in people with chronic and drug-resistant epilepsy. Chronic spontaneous recurrent seizures cause cardiorespiratory autonomic dysfunctions. Pituitary adenylate cyclase-activating polypeptide (PACAP) is neuroprotective, whereas microglia produce both pro- and anti-inflammatory effects in the CNS. During acute seizures in rats, PACAP and microglia produce sympathoprotective effect at the intermediolateral cell column (IML), whereas their action on the presympathetic rostral ventrolateral medulla (RVLM) neurons mediates proarrhythmogenic changes. We evaluated the effect of PACAP and microglia at the IML on sympathetic nerve activity (SNA), cardiovascular reflex responses, and electrocardiographic changes in the post-status epilepticus (SE) model of acquired epilepsy, and control rats. Chronic spontaneous seizures in rats produced tachycardia with profound proarrhythmogenic effects (prolongation of QT interval). Antagonism of microglia, but not PACAP, significantly reduced the SNA and the corrected QT interval in post-SE rats. PACAP and microglia antagonists did not change baroreflex and peripheral or central chemoreflex responses with varied effect on somatosympathetic responses in post-SE and control rats. We did not notice changes in microglial morphology or changes in a number of M2 phenotype in epileptic nor control rats in the vicinity of RVLM neurons. Our findings establish that microglial activation, and not PACAP, at the IML accounts for higher SNA and proarrhythmogenic changes during chronic epilepsy in rats. This is the first experimental evidence to support a neurotoxic effect of microglia during chronic epilepsy, in contrast to their neuroprotective action during acute seizures.

Topics: Animals; Baroreflex; Blood Pressure; Chronic Disease; Epilepsy, Temporal Lobe; Male; Microglia; Minocycline; Neurons; Pituitary Adenylate Cyclase-Activating Polypeptide; Rats, Wistar; Seizures; Sympathetic Nervous System

Chronic osteomyelitis is a chronic inflammatory disease induced by bone infection. It may be limited to a single portion of bone or involve several areas such as marrow, cortical, periosteum and adjacent soft tissues. Being able to persist for weeks, months or even years, it remains a therapeutic challenge in spite of the important medical and surgical advances, with a prolonged and complex management given the nature of the surgical interventions and the antibiotherapies required. We report a case of chronic osteomyelitis treated by long-term suppressive antibiotic therapy, which may be a reasonable alternative to surgery in inoperable clinical situations, but taking into account the risks associated with it in terms of side effects and selection of resistant organisms, as well as the cost of treatment and the quality of life of the patient.. L’ostéomyélite chronique est une pathologie inflammatoire chronique induite par une infection osseuse. Elle peut être limitée à une seule portion d’os ou impliquer plusieurs zones telles que la moelle, la corticale, le périoste et les tissus mous adjacents. Pouvant persister pendant des semaines, des mois voire des années, elle reste un challenge thérapeutique en dépit des importantes avancées médicales et chirurgicales, avec une prise en charge prolongée et complexe compte tenu de la nature des interventions chirurgicales et des antibiothérapies requises. Nous rapportons un cas d’ostéomyélite chronique pris en charge par antibiothérapie suppressive au long cours, qui peut être une alternative raisonnable à la chirurgie dans des situations cliniques inopérables, mais en prenant en considération les risques qui y sont associés en termes d’effets secondaires et de sélection des germes résistants, ainsi que le coût du traitement et la qualité de vie du patient.

Topics: Aged; Anti-Bacterial Agents; Chronic Disease; Drug Administration Schedule; Floxacillin; Humans; Male; Minocycline; Osteomyelitis; Rifampin

Studies have been suggested that minocycline can be a potential new agent for the treatment of depression. In addition, both oxidative stress and energy metabolism present an important role in pathophysiology of depression. So, the present study was aimed to evaluate the effects of minocycline on stress oxidative parameters and energy metabolism in the brain of adult rats submitted to the chronic mild stress protocol (CMS). After CMS Wistar, both stressed animals as controls received twice ICV injection of minocycline (160 μg) or vehicle. The oxidative stress and energy metabolism parameters were assessed in the prefrontal cortex (PF), hippocampus (HIP), amygdala (AMY) and nucleus accumbens (Nac). Our findings showed that stress induced an increase on protein carbonyl in the PF, AMY and NAc, and mynocicline injection reversed this alteration. The TBARS was increased by stress in the PF, HIP and NAc, however, minocycline reversed the alteration in the PF and HIP. The Complex I was incrased in AMY by stress, and minocycline reversed this effect, however reduced Complex I activity in the NAc; Complex II reduced in PF and AMY by stress or minocycline; the Complex II-III increased in the HIP in stress plus minocycline treatment and in the NAc with minocycline; in the PF and HIP there were a reduced in Complex IV with stress and minocycline. The creatine kinase was reduced in AMY and NAc with stress and minocycline. In conclusion, minocycline presented neuroprotector effects by reducing oxidative damage and regulating energy metabolism in specific brain areas.

Topics: Animals; Antioxidants; Brain Chemistry; Chronic Disease; Creatine Kinase; Electron Transport Complex I; Electron Transport Complex II; Energy Metabolism; Injections, Intraventricular; Male; Minocycline; Neuroprotective Agents; Oxidative Stress; Rats; Rats, Wistar; Stress, Psychological; Thiobarbituric Acid Reactive Substances

Chronic stress is considered to be a major risk factor in the development of psychopathological syndromes in humans. Cognitive impairments and long-term potentiation (LTP) impairments are increasingly recognized as major components of depression, anxiety disorders and other stress-related chronic psychological illnesses. It seems timely to systematically study the potentially underlying neurobiological mechanisms of altered cognitive and synaptic plasticity in the course of chronic stress. In the present study, a rat model of chronic unpredictable stress (CUS) induced a cognitive impairment in spatial memory in the Morris water maze (MWM) test and a hippocampal LTP impairment. CUS also induced hippocampal microglial activation and attenuated phosphorylation of glutamate receptor 1 (GluR1 or GluA1). Moreover, chronic treatment with the selective microglial activation blocker, minocycline (120 mg/kg per day), beginning 3 d before CUS treatment and continuing through the behavioral testing period, prevented the CUS-induced impairments of spatial memory and LTP induction. Additional studies showed that minocycline-induced inhibition of microglia activation was associated with increased phosphorylation of GluR1. These results suggest that hippocampal microglial activation modulates the level of GluR1 phosphorylation and might play a causal role in CUS-induced cognitive and LTP disturbances.

Topics: Animals; Behavior, Animal; Chronic Disease; Cognition; Cognition Disorders; Cytokines; Disease Models, Animal; Hippocampus; In Vitro Techniques; Inflammation Mediators; Long-Term Potentiation; Male; Maze Learning; Microglia; Minocycline; Phosphorylation; Rats, Sprague-Dawley; Receptors, AMPA; Restraint, Physical; Spatial Learning; Stress, Psychological; Time Factors

It is commonly accepted that psychological stress contributes to the development of temporomandibular joint disorders, in which chronic orofacial pain is the main symptom. However, the central mechanism underlying the development of these disorders has remained unclear. The current study was performed to determine the involvement of the glia in the trigeminal spinal subnucleus caudalis in stress-induced increases in masseter muscle hyperalgesia in rats. After being subjected to chronic restraint stress, the animals showed decreased body weight gain, behavioral changes and marked masseter allodynia. We also found that astrocytes, but not microglia, in the trigeminal subnucleus caudalis (Vc) were dramatically activated. A further analysis was undertaken to investigate the contribution of the glia; we intrathecally injected l-α-aminoadipate (astrocyte-specific inhibitor) and/or minocycline (microglia-specific inhibitor) into the stressed rats. Our results showed that l-α-aminoadipate (LAA), but not minocycline, could significantly attenuate the mechanical masseter allodynia and behavioral changes induced by restraint stress. In addition, the expression of interleukin-1β (IL-1β) and phosphorylated N-methyl-d-aspartic acid receptor 1 (p-NR1) in the Vc was significantly increased after chronic restraint stress, whereas LAA dramatically inhibited the overexpression of IL-1β and p-NR1. Taken together, these results suggest that activated astrocytes in the Vc may be one of the most important factors in the pathophysiology of masseter hyperalgesia induced by restraint stress and the following overexpression of IL-1β and excessive NMDAR phosphorylation may ultimately contribute to masseter hyperalgesia. Thus, inhibiting spinal astrocytic activation may represent a novel therapeutic strategy for the treatment of orofacial pain induced by stress.

Topics: Adipates; Animals; Astrocytes; Body Weight; Central Nervous System Agents; Chronic Disease; Disease Models, Animal; Hyperalgesia; Injections, Spinal; Interleukin-1beta; Male; Masseter Muscle; Microglia; Minocycline; Phosphorylation; Rats, Sprague-Dawley; Receptors, N-Methyl-D-Aspartate; Restraint, Physical; Stress, Psychological; Trigeminal Nucleus, Spinal

Topics: Adult; Anti-Bacterial Agents; Chronic Disease; Dose-Response Relationship, Drug; Erythema Nodosum; Female; Follow-Up Studies; Humans; Leprosy, Lepromatous; Male; Minocycline; Pilot Projects; Prospective Studies; Recurrence; Time Factors; Treatment Outcome

Topics: Aged; Anti-Bacterial Agents; Blepharitis; Chronic Disease; Female; Humans; Minocycline; Pigmentation Disorders

The aim of this study was to determine the efficacy of tigecycline-impregnated hydroxyapatite in the local treatment of chronic osteomyelitis experimentally induced in rat tibias with methicillin-resistant Staphylococcus aureus.. Monocortical defects were established in the left tibias of 32 adult Wistar albino rats. Five rats were randomly selected and injected intramedullarly with saline solution (group 1), whereas chronic osteomyelitis was induced in other rats by intramedullary injection of S. aureus. Infected rats were then randomized and divided into 4 groups: group 2, no further treatment; group 3, debridement only; group 4, debridement followed by implantation of calcium hydroxyapatite; and group 5, debridement followed by implantation of tigecycline-impregnated calcium hydroxyapatite. On day 21 after induction, all rats in groups 2-5 showed signs of osteomyelitis. Rats in groups 1 and 2 were killed on day 21 after induction, whereas rats in groups 3, 4, and 5 underwent debridement surgery on day 21 after induction and were killed 21 days after debridement surgery. Tibias were analyzed histopathologically and cultured for S. aureus.. Compared with group 2, histopathologic disease severity scores in groups 3, 4, and 5 were 37%, 44%, and 83% lower, respectively. Nontreated infected rats had the highest bacteria count (mean 5 × 10(5) colony-forming units/g bone), and bacterial count was 26%, 29%, and 79% lower in groups 3, 4, and 5, respectively, compared with group 2.. Tigecycline-impregnated hydroxyapatite can have a potential in the treatment of chronic osteomyelitis of methicillin-resistant S. aureus origin, which may be considered as a therapeutic alternative by surgeons dealing with osteomyelitis.

Topics: Animals; Anti-Bacterial Agents; Anti-Infective Agents, Local; Biocompatible Materials; Chronic Disease; Colony Count, Microbial; Debridement; Drug Carriers; Durapatite; Male; Methicillin-Resistant Staphylococcus aureus; Minocycline; Osteomyelitis; Random Allocation; Rats; Rats, Wistar; Tibia; Tigecycline

Topics: Anti-Bacterial Agents; Antimalarials; Chronic Disease; Doxycycline; Drug Therapy, Combination; Humans; Hydroxychloroquine; Lyme Disease; Minocycline

Chronic fatigue stress (CFS) is a common complaint among general population. Persistent and debilitating fatigue severely impairs daily functioning and is usually accompanied by combination of several physical and psychiatric problems. It is now well established fact that oxidative stress and neuroinflammation are involved in the pathophysiology of chronic fatigue and related disorders. Targeting both COX (cyclooxygenase) and 5-LOX (lipoxygenase) pathways have been proposed to be involved in neuroprotective effect.. In the present study, mice were put on the running wheel apparatus for 6 min test session daily for 21 days, what produced fatigue like condition. The locomotor activity and anxiety like behavior were measured on 0, 8(th), 15(th) and 22(nd) day. The brains were isolated on 22(nd) day immediately after the behavioral assessments for the estimation of oxidative stress parameters and mitochondrial enzyme complexes activity.. Pre-treatment with licofelone (2.5, 5 and 10 mg/kg, po) and minocycline (50 and 100 mg/kg, po) for 21 days, significantly attenuated fatigue like behavior as compared to the control (rotating wheel activity test session, RWATS) group. Further, licofelone (5 and 10 mg/kg, po) and minocycline (50 and 100 mg/kg, po) drug treatments for 21 days significantly attenuated behavioral alterations, oxidative damage and restored mitochondrial enzyme complex activities (I, II, III and IV) as compared to control, whereas combination of licofelone (5 mg/kg) with minocycline (50 mg/kg) significantly potentiated their protective effect which was significant as compared to their effect per se.. The present study highlights the therapeutic potential of licofelone, minocycline and their combination against CFS in mice.

Topics: Animals; Chronic Disease; Drug Therapy, Combination; Fatigue; Glutathione; Lipid Peroxidation; Male; Maze Learning; Mice; Minocycline; Mitochondria; Motor Activity; Pyrroles; Stress, Psychological

Topics: Adult; Anti-Bacterial Agents; Chronic Disease; Erythema Nodosum; Female; Humans; Hyperpigmentation; Minocycline; Recurrence; Tetracycline

We previously reported that minocycline attenuates acute brain injury and inflammation after focal cerebral ischemia, and this is partly mediated by inhibition of 5-lipoxygenase (5-LOX) expression. Here, we determined the protective effect of minocycline on chronic ischemic brain injury and its relation with the inhibition of 5-LOX expression after focal cerebral ischemia.. Focal cerebral ischemia was induced by 90 min of middle cerebral artery occlusion followed by reperfusion for 36 days. Minocycline (45 mg/kg) was administered intraperitoneally 2h and 12h after ischemia and then every 12h for 5 days. Sensorimotor function was evaluated 1-28 days after ischemia and cognitive function was determined 30-35 days after ischemia. Thereafter, infarct volume, neuron density, astrogliosis, and 5-LOX expression in the brain were determined.. Minocycline accelerated the recovery of sensorimotor and cognitive functions, attenuated the loss of neuron density, and inhibited astrogliosis in the boundary zone around the ischemic core, but did not affect infarct volume. Minocycline significantly inhibited the increased 5-LOX expression in the proliferated astrocytes in the boundary zone, and in the macrophages/microglia in the ischemic core.. Minocycline accelerates functional recovery in the chronic phase of focal cerebral ischemia, which may be partly associated with the reduction of 5-LOX expression.

Topics: Agnosia; Animals; Astrocytes; Brain; Brain Ischemia; Cell Count; Cell Proliferation; Chronic Disease; Immunohistochemistry; Injections, Intraperitoneal; Lipoxygenase Inhibitors; Macrophages; Male; Maze Learning; Microglia; Minocycline; Neurons; Neuroprotective Agents; Rats; Rats, Sprague-Dawley; Recovery of Function

Topics: Animals; Chronic Disease; Demyelinating Diseases; Disease Models, Animal; Humans; Hyponatremia; Minocycline; Osmotic Pressure; Rats; Sodium; Time Factors

There is increasing evidence that spinal glial cells play an important role in chronic pain states. However, so far no data on the role of microglia in muscle pain are available. The aim of the present study was to investigate the involvement of spinal microglial cells in chronic muscle pain. In a rat model of chronic muscle inflammation (injection of complete Freund s adjuvant into the gastrocnemius-soleus muscle) alterations of microglia were visualized with quantitative OX-42 immunohistochemistry in the dorsal horn of the segments L4 and L5 12 days after induction of inflammation. In behavioural experiments the influence of chronic intrathecally applied minocycline - a specific microglia inhibitor - or an antibody against tumour necrosis factor-alpha (TNF-alpha; a cytokine released from microglia) on pain-related behaviour was investigated after 1, 3, 6, and 12 days. The immunhistochemical data show that in the deep laminae of the spinal dorsal horn microglial cells reacted with morphological changes to the muscle inflammation. Following inflammation, the mean boundary length surrounding the OX-42 immunostained area was significantly shorter. This indicates that microglial cells were activated by the myositis and withdrew their processes. Chronic intrathecal administration of minocycline or anti TNF-alpha with an osmotic mini-pump largely normalised the inflammation-induced changes in spontaneous exploratory behaviour and attenuated the hypersensitivity to mechanical stimulation. Both the immunohistochemical and behavioural data show that spinal microglial cells are involved in nociceptive processes in the cause of a chronic muscle inflammation.

Topics: Animals; Anti-Bacterial Agents; Antibodies; Biomarkers; CD11b Antigen; Cell Shape; Chronic Disease; Disease Models, Animal; Exploratory Behavior; Freund's Adjuvant; Hyperalgesia; Immunohistochemistry; Male; Microglia; Minocycline; Myositis; Nociceptors; Pain Threshold; Pain, Intractable; Posterior Horn Cells; Rats; Rats, Sprague-Dawley; Tumor Necrosis Factor-alpha

To report our experience with minocycline-induced autoimmunity (MIA) in children, with an emphasis on the potential for chronicity.. Retrospective cohort study of patients with development of rheumatologic symptoms while receiving minocycline between 1996 and 2006.. Twenty-seven children were diagnosed with MIA at a single pediatric rheumatology practice. The mean age at onset was 16.5 +/- 1.39 years. The mean duration of minocycline use before diagnosis was 13.0 +/- 10.8 months. All patients presented with constitutional symptoms. Twenty-two had polyarthralgia, and 17 had polyarthritis, mostly affecting hands and feet. On the basis of disease duration after discontinuation of minocycline, we divided subjects into 3 categories: transient, intermediate, and chronic. Seven patients had development of chronic autoimmune disease that was still active at last follow-up, a mean of 31.6 +/- 13.0 (13-48) months after onset. Six patients followed an intermediate course, with resolution of symptoms within 12 months, and 14 patients had symptoms that resolved rapidly on discontinuation of minocycline. All patients with a chronic course had evidence of arthritis at presentation.. A substantial proportion of children with MIA had development of chronic symptoms with the potential for significant morbidity. Physicians who prescribe minocycline should be aware of its propensity for inducing potentially serious autoimmune phenomena.

Topics: Adolescent; Anti-Bacterial Agents; Antibodies, Antineutrophil Cytoplasmic; Antibodies, Antinuclear; Antibodies, Antiphospholipid; Arthritis; Autoantibodies; Autoimmune Diseases; Autoimmunity; Chronic Disease; Enzyme-Linked Immunosorbent Assay; Female; Fluorescent Antibody Technique, Indirect; Follow-Up Studies; Humans; Male; Minocycline; Prognosis; Retrospective Studies; Time Factors

There are few treatments that address both papulopustular and telangiectatic components of rosacea. We present a case of rosacea that was unresponsive to treatment with antibiotics. We report the novel use of a new laser technology, the multiplexed laser, for treatment of both papular and telangiectatic rosacea.

Topics: Administration, Cutaneous; Anti-Bacterial Agents; Chronic Disease; Combined Modality Therapy; Female; Humans; Low-Level Light Therapy; Middle Aged; Minocycline; Rosacea; Time Factors

Traumatic spinal cord injury (SCI) results not only in motor impairment but also in chronic central pain, which can be refractory to conventional treatment approaches. It has been shown recently that in models of peripheral nerve injury, spinal cord microglia can become activated and contribute to development of pain. Considering their role in pain after peripheral injury, and because microglia are known to become activated after SCI, we tested the hypothesis that activated microglia contribute to chronic pain after SCI. In this study, adult male Sprague Dawley rats underwent T9 spinal cord contusion injury. Four weeks after injury, when lumbar dorsal horn multireceptive neurons became hyperresponsive and when behavioral nociceptive thresholds were decreased to both mechanical and thermal stimuli, intrathecal infusions of the microglial inhibitor minocycline were initiated. Electrophysiological experiments showed that minocycline rapidly attenuated hyperresponsiveness of lumbar dorsal horn neurons. Behavioral data showed that minocycline restored nociceptive thresholds, at which time spinal microglial cells assumed a quiescent morphological phenotype. Levels of phosphorylated-p38 were decreased in SCI animals receiving minocycline. Cessation of delivery of minocycline resulted in an immediate return of pain-related phenomena. These results suggest an important role for activated microglia in the maintenance of chronic central below-level pain after SCI and support the newly emerging role of non-neuronal immune cells as a contributing factor in post-SCI pain.

Topics: Animals; Chronic Disease; Male; Microglia; Minocycline; Motor Activity; Pain; Rats; Rats, Sprague-Dawley; Spinal Cord Injuries; Thoracic Vertebrae

The microflora that develops on minocycline strips, used as an adjunct in non-surgical periodontal therapy was studied.. Minocycline (1.4 mg in polycaprolactone vehicle) and control strips were applied into all residual pockets (PD > or = 5mm, > or =2 pockets/subject) of patients with chronic periodontitis 1 month after a course of non-surgical periodontal therapy. Strips were inserted and retained for 3 days, changed to new strips for 3 more days and then removed. Strips were recovered from 14 (eight test, six control) of the 34 participants at day 0 (strip inserted, left for 30 s, removed), days 3 and 6, for (i) anaerobic culture, (ii) coliforms culture, using MacConkey agar, (iii) yeast culture, using Sabouraud's dextrose agar.. The mean anaerobic cfu/strip (x10(5); control/test) were 2/6, 24/2, 11/2 at days 0, 3 and 6, respectively (P > 0.05). The corresponding mean proportion of Gram-negative rods and fusiforms were 27%/21%, 27%/15% and 55%/8%. The proportions of Gram-negative rods on test strips by day 6 were significantly reduced (P < 0.05). A significantly increased prevalence of Streptococcus mitis biovar 1 was found on spent test strips (control versus test; 0% versus 38%, Fisher exact test, P = 0.01). Coliform prevalence at days 0, 3 and 6 on control/test strips were 0/13%, 50%/38% and 50%/13%. Yeasts were occasionally isolated.. The findings indicated that the minocycline strips but not the control strip supported a microbial colonisation compatible with periodontal health by day 6.

Topics: Administration, Oral; Anti-Bacterial Agents; Bacteria, Aerobic; Bacteria, Anaerobic; Chronic Disease; Colony Count, Microbial; Enterobacteriaceae; Female; Gram-Negative Facultatively Anaerobic Rods; Humans; Male; Middle Aged; Minocycline; Periodontal Pocket; Periodontium; Pharmaceutical Vehicles; Streptococcus mitis; Yeasts

Apart from its devastating impact on individuals and their families, multiple sclerosis (MS) creates a huge economic burden for society by mainly afflicting young adults in their most productive years. Although effective strategies for symptom management and disease modifying therapies have evolved, there exists no curative treatment yet. Worldwide, MS prevalence parallels the distribution of the Lyme disease pathogen Borrelia (B.) burgdorferi, and in America and Europe, the birth excesses of those individuals who later in life develop MS exactly mirror the seasonal distributions of Borrelia transmitting Ixodes ticks. In addition to known acute infections, no other disease exhibits equally marked epidemiological clusters by season and locality, nurturing the hope that prevention might ultimately be attainable. As minocycline, tinidazole and hydroxychloroquine are reportedly capable of destroying both the spirochaetal and cystic L-form of B. burgdorferi found in MS brains, there emerges also new hope for those already afflicted. The immunomodulating anti-inflammatory potential of minocycline and hydroxychloroquine may furthermore reduce the Jarisch Herxheimer reaction triggered by decaying Borrelia at treatment initiation. Even in those cases unrelated to B. burgdorferi, minocycline is known for its beneficial effect on several factors considered to be detrimental in MS. Patients receiving a combination of these pharmaceuticals are thus expected to be cured or to have a longer period of remission compared to untreated controls. Although the goal of this rational, cost-effective and potentially curative treatment seems simple enough, the importance of a scientifically sound approach cannot be overemphasised. A randomised, prospective, double blinded trial is necessary in patients from B. burgdorferi endemic areas with established MS and/or Borrelia L-forms in their cerebrospinal fluid, and to yield reasonable significance within due time, the groups must be large enough and preferably taken together in a multi-centre study.

Topics: Animals; Anti-Bacterial Agents; Borrelia burgdorferi Group; Chronic Disease; Drug Therapy, Combination; Humans; Hydroxychloroquine; Ixodes; Lyme Disease; Minocycline; Multiple Sclerosis; Prevalence; Seasons; Secondary Prevention; Tinidazole

Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Chlorhexidine; Chronic Disease; Delayed-Action Preparations; Doxycycline; Drug Delivery Systems; Humans; Microspheres; Minocycline; Periodontitis

Topics: Adult; Amoxicillin; Anti-Bacterial Agents; Chlorhexidine; Chronic Disease; Combined Modality Therapy; Dental Scaling; Evidence-Based Medicine; Humans; Metronidazole; Minocycline; Periodontal Index; Periodontitis; Research Design; Root Planing; Tetracycline; Treatment Outcome

The objective of this research was to determine the effect of oral minocycline on the meibomian gland nonpolar and free fatty acid lipids of chronic blepharitis patients. Patients--seborrheic blepharitis (SBBL), acne rosacea (AR) without ocular involvement, and acne rosacea with meibomianitis (AR-MKC). Minocycline treatment--50mg orally for 2 weeks followed by 100mg to the end of 3 months; this was followed by 3 more months with no treatment. Meibomian gland secretions (meibum) were collected before treatment, at the end of the 3 months on treatment, and 3 months after stopping treatment. Lipids were separated and analyzed for wax and sterol esters, triglycerides, diglycerides, free cholesterol and free fatty acids. Data were analyzed statistically by ANOVA. Minocycline treatment resulted in decreased diglycerides and free fatty acids in the group AR-MKC, which continued into the second 3 months (off treatment) and was significant. Cholesterol decreased, but triglycerides initially decreased with treatment and then increased when treatment in the group was discontinued (second 3 months); these results, however, were not significant. Thus, minocycline has its greatest effect on lipid types, which result from degradation (lipase) reactions, suggesting a lipase inhibition effect and/or direct effect on ocular flora. This minocycline effect continues even after treatment is discontinued, suggesting a more lasting effect on ocular microflora. Minocycline may be most effective when the treatment period is longer than 3 months. These results give insight into disease mechanisms associated with chronic blepharitis.

Topics: Analysis of Variance; Blepharitis; Chronic Disease; Diglycerides; Drug Administration Schedule; Fatty Acids, Nonesterified; Follow-Up Studies; Humans; Lipid Metabolism; Meibomian Glands; Minocycline; Rosacea

Lupoid sycosis is a rare cicatricial form of chronic folliculitis commonly seen in men after puberty. It usually involves the beard area and is refractory to treatment. We here report two cases of lupoid sycosis; one had additional involvement of the pubic area. Both patients showed complete clearance with minocycline.

Topics: Adult; Biopsy, Needle; Chronic Disease; Facial Dermatoses; Folliculitis; Follow-Up Studies; Humans; Immunohistochemistry; Male; Minocycline; Pubic Bone; Severity of Illness Index; Treatment Outcome

This article addresses the benefits of using minocycline microspheres as an adjunct to conventional periodontal therapy. The author reviewed data from a large controlled clinical trial. The investigation indicated that scaling and root planing, plus minocycline microspheres, attained statistically significant improvements, with regard to several clinical parameters, when compared with scaling and root planing alone. Because it is the clinical meaningfulness of data that determines whether a therapy should be implemented, these data are interpreted with respect to their clinical relevance.

Topics: Anti-Bacterial Agents; Chronic Disease; Combined Modality Therapy; Data Interpretation, Statistical; Dental Scaling; Gingival Hemorrhage; Humans; Microspheres; Minocycline; Odds Ratio; Periodontal Pocket; Periodontitis; Root Planing; Treatment Outcome

To elucidate the treatment of Ureaplasma urealyticum (UU) and Chlamydia trachomatis (CT) infectious chronic prostatitis.. Forty-eight cases of chronic prostatitis patients with UU and CT infections were treated with minocycline, Chinese medicine "Qianlieshulekeli" and alpha 1A adrenoceptorblocker (tamsulosin) for 6 weeks. The change of symptoms, expressed prostatic secretion (EPS) routine, and UU and CT detection results were observed before and after the treatment. The efficacy of treatment were evaluated by CPSI score.. Remarkably effective-41 cases (85.4%), effective-5 cases (10.4%), noneffective-2 cases (4.2%). CPSI score reduced from (22 +/- 8) before treatment to (7 +/- 3) after treatment (P < 0.01). UU in 20 of 24 cases (83%) and CT in 25 of 28 cases (89%) turned negative after treatment.. The therapy combining Chinese medicine with western medicine for the treatment of UU and CT infectious chronic prostatitis is successful.

Topics: Adolescent; Adult; Chlamydia Infections; Chlamydia trachomatis; Chronic Disease; Drug Therapy, Combination; Humans; Male; Medicine, Chinese Traditional; Minocycline; Prostatitis; Ureaplasma Infections; Ureaplasma urealyticum

We have explored the use of minocycline, a tetracycline with antiinflammatory properties, to treat chronic relapsing-remitting experimental allergic encephalomyelitis, an animal model of multiple sclerosis. Therapeutic treatment with minocycline dramatically suppresses ongoing disease activity and limits disease progression. Disease suppression is associated with immune deviation in the periphery and with suppression of the inflammatory cascade in the central nervous system. This association is demonstrated by inhibition of microglial activation and metalloproteinase-2 expression, which results in a concomitant decrease in inflammation and demyelination. As an established antiinflammatory drug with neuroprotective properties, minocycline may provide a novel therapeutic agent for relapsing-remitting multiple sclerosis.

Topics: Animals; Anti-Bacterial Agents; Brain; Chronic Disease; Encephalomyelitis, Autoimmune, Experimental; Female; Immunization; Minocycline; Myelin Proteins; Myelin-Associated Glycoprotein; Myelin-Oligodendrocyte Glycoprotein; Rats; Recurrence; Th1 Cells; Th2 Cells

In addition to their antimicrobial properties, tetracyclines have antiinflammatory and pro-anabolic effects on the reparatory potential of connective tissue and bone. The physiologically active androgen 5alpha-dihydrotestosterone (DHT) implicated in matrix synthesis is formed in gingivae from androgen substrates. The aim of this investigation is to study the androgen metabolic response of gingivae to minocycline, in the presence or absence of the anti-androgen finasteride. Chronically inflamed gingival tissue derived from 12 subjects aged 30-50 years and passaged fibroblasts derived from this source, were used for the experiments. Duplicate incubations were performed in Eagle's MEM with 14C-testosterone/14C-4-androstenedione in the presence or absence of minocycline (5-60 microg/ml) or finasteride for 24 h. The androgen substrate 14C-testosterone was metabolised mainly to DHT and 4-androstenedione, while 14C-4-androstenedione was converted mainly to DHT and testosterone. Minocycline at 20-30 microg/ml stimulated the formation of these metabolites from both substrates by 13-25%. In the tissue incubations there were 3- and 2-fold increases in DHT and 4-androstenedione formation (n=12; p<0.01). The anti-androgen finasteride caused significant inhibition of 5alpha-reductase activity on both substrates at 0.1 & 1.0 microg/ml with total inhibition at 10 & 50 microg/ml (n=3; p<0.01). Minocycline-induced stimulation of 5alpha-reductase activity was also inhibited by finasteride (n=4; p<0.02). Since finasteride inhibition of 5alpha-reductase activity is specific for the type 2 isoenzyme associated with anabolic functions of target tissue, this enzyme activity may contribute to some of the cited anabolic tissue responses to minocycline.

Topics: 5-alpha Reductase Inhibitors; Adult; Androgen Antagonists; Androstenedione; Anti-Bacterial Agents; Carbon Radioisotopes; Cells, Cultured; Chronic Disease; Culture Media; Dihydrotestosterone; Dose-Response Relationship, Drug; Enzyme Inhibitors; Fibroblasts; Finasteride; Gas Chromatography-Mass Spectrometry; Gingiva; Gingivitis; Humans; Isoenzymes; Middle Aged; Minocycline; Radiopharmaceuticals; Testosterone

Topics: Adult; Anti-Bacterial Agents; Chronic Disease; Facial Dermatoses; Folliculitis; Follow-Up Studies; Humans; Male; Minocycline

We report a case of pulmonary Nocardia (N.) otitidiscaviarum infection in a 76-year-old man with chronic respiratory infection. The patient responded poorly to intravenous imipenem and oral minocycline, but later improved after treatment with trimethoprim-sulfamethoxazole. Pulmonary infection with N. otitidiscaviarum should be considered in the differential diagnosis of chronic respiratory infections. Further studies are needed to evaluate the correlation between species and drug susceptibility.

Topics: Aged; Agricultural Workers' Diseases; Bronchoalveolar Lavage Fluid; Chronic Disease; Drug Resistance, Microbial; Drug Therapy, Combination; Humans; Imipenem; Male; Microbial Sensitivity Tests; Minocycline; Nocardia; Nocardia Infections; Opportunistic Infections; Pneumonia, Bacterial; Species Specificity; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Acne Vulgaris; Anti-Bacterial Agents; Chronic Disease; Female; Humans; Middle Aged; Minocycline; Nephritis, Interstitial

Periodontitis, similar to other infectious diseases, is known to progress as chronic inflammation with recurrent acute phases. The purpose of this study was to clarify the microbiological composition of the acute phase and to compare the bacterial flora with that of comparable chronic periodontal pockets. We also evaluated the effect of application of minocycline gel locally on the change in the microflora in the acute pockets. Microbial flora from the subgingival pockets of 28 patients in the acute phase of periodontitis and of 12 patients in a comparable chronic phase as the control were investigated by various bacterial culture methods including TS blood agar and TSBV plates. Minocycline gel was applied to the acute periodontal pockets. Changes in the microbiological proportion and clinical parameters at one week after baseline examination were followed by dark-field analysis, culture method, and indirect immunofluorescence technique. Characteristic features of bacterial proportions in the acute site were observed as an increase in Bacteroides forsythus. The number of Porphyromonas gingivalis and black pigmented anaerobic rods also increased. Application of minocycline gel in the acute pocket without any debridement produced improvement in clinical symptoms at one week. Black-pigmented anaerobic rods, P. gingivalis, and B. forsythus decreased significantly at one week after the application. Results indicate that periodontopathic bacteria including B. forsythus and P. gingivalis were predominant in the acute phase of periodontitis and a locally delivered antibiotic may be effective as an alternative modality of treating the acute inflammation.

Topics: Acute Disease; Administration, Topical; Anti-Bacterial Agents; Bacteroides; Chronic Disease; Colony Count, Microbial; Delayed-Action Preparations; Female; Fluorescent Antibody Technique, Indirect; Gels; Humans; Male; Middle Aged; Minocycline; Periodontal Pocket; Periodontitis; Porphyromonas gingivalis; Statistics, Nonparametric

Tetracycline in combination with scaling and root planing is frequently used to treat refractory periodontal disease. This study examined tetracycline resistance in bacteria recovered from periodontal pockets of patients with refractory periodontitis. Bacterial isolates resistant to 10 micrograms/ml of tetracycline were isolated from plaque samples of 17 patients, of whom 6 had received tetracycline within 8 weeks prior to sampling. Minimal inhibitory concentrations (MICs) of tetracycline and minocycline were determined by agar dilution. In the 6 patients who had received tetracycline, a mean of 22.9% (+/- 38.2) of the total cultivable subgingival flora were resistant to tetracycline, compared with a mean of 7.2% (+/- 8.5) in the untreated group. Although various organisms were isolated, in most patients, the tetracycline-resistant organisms were dominated by Streptococcus spp. Overgrowth of Candida was found in one patient, and of Enterobacteriaceae in another patient, while small numbers of yeast or Staphylococcus spp. were isolated from the plaque samples of 9 others. 3 out of 4 patients who did not respond to tetracycline treatment had a variety of tetracycline-resistant anaerobic Gram-negative rods present. No correlation was found between increased proportions of tetracycline resistance in the whole bacterial sample and the presence of resistant periodontal pathogens.

Topics: Adult; Chronic Disease; Colony Count, Microbial; Dental Plaque; Enterobacteriaceae; Gram-Negative Anaerobic Bacteria; Humans; Microbial Sensitivity Tests; Middle Aged; Minocycline; Periodontal Pocket; Periodontitis; Streptococcus; Tetracycline; Tetracycline Resistance

The chemotherapeutic activity of minocycline, a semi-synthetic tetracycline analogue, was evaluated in a murine model of toxoplasmosis. A lethal acute toxoplasmosis was produced by injecting 10(5) tachyzoites of the RH strain of Toxoplasma gondii into the peritoneal cavities of Swiss-Webster mice. When infected mice were treated once daily for 12 days, starting 2 h after challenge, the survival and cure rates were 100% and 40% respectively after minocycline alone (100 mg/kg per day), 0% and 0% after pyrimethamine alone (8.5 mg/kg per day), and 100% and 50% after combination of the two drugs at the same dosages. Absolute survival and cure with minocycline were observed when mice were treated with two daily doses of 100 mg/kg for 12 days. Mice chronically infected with a low virulent strain of T. gondii (Me49) showed a significant reduction in the number of brain cysts after three weeks of treatment with 50 mg/kg per day of minocycline. Minocycline serum levels after a single oral administration of 50 mg/kg or 100 mg/kg to normal mice, peaked at 1.8 mg/l and 10 mg/l after 1 h, respectively, and showed an extended half-life.

Topics: Acute Disease; Animals; Chronic Disease; Drug Evaluation, Preclinical; Female; Mice; Minocycline; Pyrimethamine; Remission Induction; Toxoplasmosis, Animal

Superficial granulomatous pyoderma, recently described as a variant of pyoderma gangrenosum, would be better termed pathergic granulomatous cutaneous ulceration as the seven previously described cases, as well as our own two cases, have significant dermal involvement histologically and heal with scarring. In contrast to pyoderma gangrenosum, lesions of superficial granulomatous pyoderma respond to less toxic anti-inflammatory agents.

Topics: Adult; Chronic Disease; Dapsone; Diagnosis, Differential; Granuloma; Humans; Male; Minocycline; Pyoderma; Recurrence; Skin Ulcer

The effects of minocycline on subgingival plaque samples from patients with chronic periodontitis were investigated in vitro. Minocycline concentrations as low as 1.0 microgram/ml inhibited 95.7% of the cultivable bacteria in the samples but 256 micrograms/ml was necessary to inhibit all of the cultivable bacteria in the samples. Although up to 99.9% of bacteria in the plaque samples were killed by a 6 h exposure to 8.0 micrograms/ml of minocycline, large numbers of viable bacteria remained. These results imply that adequate reductions in the numbers of viable subgingival plaque bacteria are unlikely to occur after exposure to minocycline at concentrations attainable in gingival crevicular fluid after systemic administration.

Topics: Adult; Aged; Bacteria; Chronic Disease; Colony Count, Microbial; Dental Plaque; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Minocycline; Periodontitis; Time Factors

Topics: Aged; Autopsy; Bronchitis; Chronic Disease; Humans; Male; Minocycline; Pigmentation Disorders; Skin; Tetracyclines; Tissue Distribution

Ureaplasma urealyticum has been considered to be a pathogen of nongonococcal urethritis. To elucidate the pathogenicity of this microorganism in chronic prostatitis, U. urealyticum was isolated from patients with chronic prostatitis and prostatodynia. Using the Taylor-Robinson's method, U. urealyticum was detected in expressed prostatic secretion (EPS) or urine voided after prostatic massage (VB3) in 40 (41.2%) out of 97 patients with chronic prostatitis and 6 (20.0%) out of 30 patients with prostatodynia. Seventeen patients with U. urealyticum-positive chronic prostatitis, 13 of whom had failed to respond to the treatment by other antimicrobial agents, were treated with minocycline. In 16 (94.1%) of the 17 patients, U. urealyticum was eradicated and in 14 patients (82.4%), the elevated white blood cell count was markedly lowered in EPS or VB3. U. urealyticum may prove to be an etiological microorganism of chronic prostatitis.

Topics: Chronic Disease; Humans; Male; Minocycline; Pain; Prostatic Diseases; Prostatitis; Ureaplasma

Review of the treatment of chronic non-bacterial prostatitis, defined by the presence of more than 500 leucocytes per mm3 in the expressed prostatic secretion (EPS), showed symptomatic response after 3 months of minocycline, trimethoprim, co-trimoxazole or diazepam. Reduction in the EPS cell count was most marked with minocycline, trimethoprim was less effective and poor results were obtained with co-trimoxazole and diazepam. In the absence of established treatment for chronic non-bacterial prostatitis it is suggested that antimicrobial therapy is worth consideration.

Topics: Adult; Anti-Infective Agents, Urinary; Chronic Disease; Diazepam; Drug Combinations; Humans; Leukocyte Count; Male; Minocycline; Prostate; Prostatitis; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

A 47-year-old man with chronic osteomyelitis of the mandible is described. The patient had frequent episodes of acute and subacute exacerbation at varying intervals for a period of six years in spite of extended antibiotic therapy. Intraarterial infusion of antibiotics through the superficial temporal artery also failed to cause any improvement. He was finally treated successfully by surgical intervention.

Topics: Cephalexin; Chronic Disease; Drug Resistance; Humans; Injections, Intra-Arterial; Male; Mandibular Diseases; Middle Aged; Minocycline; Necrosis; Osteomyelitis; Tetracyclines

Topics: Acute Disease; Antibiotics, Antitubercular; Bacterial Infections; Cephalexin; Chronic Disease; Clindamycin; Drug Combinations; Erythromycin; Gentamicins; Humans; Methods; Minocycline; Otorhinolaryngologic Diseases; Penicillins; Streptomycin; Tobramycin

After the administration of minocycline, doxycyline and tetracycline in recommended therapeutic doses to 11, 10 and 12 patients respectively, sputum levels of these antibiotics were determined. Only 20% of patients given doxcycline had a satisfactory sputum level and in the remainder levels were either low or absent. For patients receiving tetracycline and minocycline, 67% and 64% respectively had satisfactory sputum levels. Patients selected for this study had a history of chronic bronchitis and were producing copious amounts of purulent sputum. Minimum inhibitory concentrations of these three antibiotics were similar for 25 freshly isolated strains of Haemophilus influenzae, with minocycline being the most inhibitory and doxcycline the least inhibitory.

Topics: Anti-Bacterial Agents; Bronchitis; Chronic Disease; Doxycycline; Haemophilus influenzae; Humans; Minocycline; Sputum; Tetracycline; Tetracyclines

The results of minocycline and doxycycline therapy in 41 patients with chronic prostatitis and minocycline therapy in 6 patients with acute prostatitis were evaluated. In the comparative study of chronic prostatitis, minocycline and doxycycline were given on the same dosage schedule, milligram for milligram: a loading dose of 200 mg. followed by 100 mg. twicd daily. Over-all clinical responses to therapy with either agent were generally satisfactory, and no statistically significant difference was demonstrable in this regard. In the group with chronic prostatitis treated wtih minocycline, however, all symptoms manifested before therapy had disappeared after therapy even where over-all results had been judged unsatisfactory. This was not true of the group with chronic prostatitis treated with doxycycline. Symptoms in 6 patients persisted after therapy had been terminated. Here the difference in results between the two groups was found to be statistically significant. A review of symptoms two to eight weeks after therapy revealed no significant difference between the two groups. After two years only 6 patients in the entire group with chronic prostatitis had returned with recurrent problems: 3 of these patients had been treated with minocycline and 3 had been treated with doxycycline. Results of therapy in the small series of patients with acute prostatitis treated with minocycline were generally satisfactory.

Topics: Chronic Disease; Dose-Response Relationship, Drug; Doxycycline; Escherichia; Escherichia coli; Humans; Klebsiella; Male; Minocycline; Prostatitis; Proteus mirabilis; Recurrence; Staphylococcus; Tetracyclines

Serum and sputum levels of minocycline, doxycycline and tetracycline were determined in patients with chronic bronchitis who were producing copious amounts of purulent sputum. Antibiotic estimations were carried out by the plate agar diffusion method using the Oxford staphylococcus. A close correlation was obtained between the sputum and the average serum levels for patients receiving tetracycline. Values obtained for minocycline showed a poor correlation between serum and sputum. A correlation between serum and sputum levels of doxycycline could not be established due to the low levels present in sputum. Our results indicate that while adequate serum levels of tetracycline reflect the attainment of theapeutic concentrations in bronchial secretions; the same predictions cannot be made for minocycline or doxycycline.

Topics: Bronchitis; Chronic Disease; Doxycycline; Humans; Minocycline; Sputum; Tetracycline; Tetracyclines

Topics: Acute Kidney Injury; Chronic Disease; Female; Humans; Kidney; Kidney Diseases; Male; Minocycline; Regression Analysis; Tetracyclines; Time Factors

Topics: Adult; Asthma; Bronchitis; Chronic Disease; Dose-Response Relationship, Drug; Haemophilus influenzae; Humans; Infusions, Parenteral; Kidney; Liver; Male; Microbial Sensitivity Tests; Middle Aged; Minocycline; Sputum; Staphylococcus; Tetracycline; Tetracyclines