minocycline and Diarrhea

Tetracyclines are a group of broad-spectrum antibiotics largely employed in infectious, dermatological and surgical fields. Some adverse events may occur during treatment, including photosensitivity reactions, which are divided in phototoxic or photoallergic. We performed a systematic search on Pubmed, Cochrane and Embase from database inception to August 9, 2020 aim to summarize all available papers on photosensitive reactions related to tetracyclines in all clinical settings where they are used on human being. On the basis of our inclusion criteria, we selected only randomized controlled trials, open comparative trials and prospective cohort studies performed on both volunteers and patients, moreover we included a pharmacovigilance register. Thirty-eight articles met inclusion criteria, describing photo-sensitive effects due to doxycycline, minocycline, tetracycline, lymecycline, sarecycline, demethylchlortetracycline, chlortetracycline and metacycline, across six diagnoses (acne, Lyme disease, Gulf Veteran Illness, adbominal aortic aneurysms, traveler's diarrhea and pterygium) and several volunteers who were deliberately exposed to natural or artificial light sources. Not all drugs belonging to tetracyclines class are available to date, moreover the studies included lacked a homogeneous design and most of them involved a scarce number of patients, including reactions induced in volunteers during photo-testing. Available data on incidence, severity and clinical relevance of tetracyclines-related photo-sensitive reactions are scarce, heterogeneous and weak. What we can extrapolate is that some tetracyclines are more often related to phototoxic skin reactions than others and some of those seem to have a very low risk of phototoxicity.

Topics: Anti-Bacterial Agents; Diarrhea; Humans; Minocycline; Prospective Studies; Travel

Clostridium difficile infection (CDI) has become the most frequent cause of nosocomial infectious diarrhoea in developed countries, causing an increase in mortality, recurrences or treatment failure. In the search for new and more effective drugs, researchers recently turned their attention to tigecycline, a broad-spectrum antibiotic of the glycylglycine class available as an intravenous formulation for human use, which has also shown in vitro activity against C. difficile. We performed a literature review of articles addressing in vitro as well as in vivo studies and case reports on the effectiveness of tigecycline, whose use is promising especially in light of its high faecal excretion. The available evidence suggests that tigecycline could play a role as an alternative therapeutic option for critically ill patients or cases of refractory CDI.

Topics: Anti-Bacterial Agents; Clostridioides difficile; Clostridium Infections; Diarrhea; Humans; Minocycline; Tigecycline; Treatment Outcome

Tigecycline, an expanded broad-spectrum glycylcycline, exhibits in vitro activity against many common pathogens associated with community-acquired pneumonia (CAP), as well as penetration into lung tissues that suggests effectiveness in hospitalized CAP patients. The aim of the present study was to compare the efficacy and safety of intravenous (IV) tigecycline with IV levofloxacin in hospitalized adults with CAP.. In this prospective, double-blind, non-inferiority phase 3 trial, eligible patients with a clinical diagnosis of CAP supported by radiographic evidence were stratified by Fine Pneumonia Severity Index and randomized to tigecycline or levofloxacin for 7-14 days of therapy. Co-primary efficacy endpoints were clinical response in the clinically evaluable (CE) and clinical modified intent-to-treat (c-mITT) populations at test-of-cure (Day 10-21 post-therapy).. Of the 428 patients who received at least one dose of study drug, 79% had CAP of mild-moderate severity according to their Fine score. Clinical cure rates for the CE population were 88.9% for tigecycline and 85.3% for levofloxacin. Corresponding c-mITT population rates were 83.7% and 81.5%, respectively. Eradication rates for Streptococcus pneumoniae were 92% for tigecycline and 89% for levofloxacin. Nausea, vomiting, and diarrhoea were the most frequently reported adverse events. Rates of premature discontinuation of study drug or study withdrawal because of any adverse event were similar for both study drugs.. These findings suggest that IV tigecycline is non-inferior to IV levofloxacin and is generally well-tolerated in the treatment of hospitalized adults with CAP.. NCT00081575.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Community-Acquired Infections; Diarrhea; Dose-Response Relationship, Drug; Double-Blind Method; Female; Humans; Infusions, Intravenous; Levofloxacin; Male; Middle Aged; Minocycline; Nausea; Ofloxacin; Pneumonia, Bacterial; Prospective Studies; Severity of Illness Index; Tigecycline; Treatment Outcome; Vomiting; Young Adult

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

The management of skin toxicity is crucial for efficient afatinib treatment, but the role of tetracycline class antibiotics (TCs) in managing these rashes is relatively unknown.. We reviewed the clinical records of patients who were administered afatinib for the treatment of non-small cell lung cancer harboring epidermal growth factor receptor mutations between October 2014 and November 2016. Twenty-five patients, who received TCs for the management of afatinib-related skin disorders, were enrolled.. Minocycline was administered orally to participants. Afatinib-related toxic effects, such as rash, diarrhea, and paronychia, were observed in 92%, 92%, and 40% of cases, respectively. Although 24% of diarrhea and 4% of paronychia cases were rated grade 3 or higher, no severe cases of rash were observed during afatinib treatment. Of the 18 afatinib dose reductions, 14 (78%), three (17%), and one (6%) resulted from diarrhea, paronychia, and stomatitis, respectively; no patients required a dose reduction because of rash. When minocycline treatment started, 21 patients (84%) had a rash of grade 1 or less, and three patients had a grade 2 rash. A response to afatinib was observed in 18 patients (72%) and the median duration of afatinib administration was 501 days. An adverse event related to minocycline (grade 1 nausea) was observed in one patient.. A large proportion of the study patients started minocycline before grade 2 rash development and the severity of afatinib-related rash was lower than that previously reported. Oral TCs may be beneficial, especially if started early.

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Carcinoma, Non-Small-Cell Lung; Diarrhea; Epidermal Growth Factor; Exanthema; Female; Humans; Lung Neoplasms; Male; Middle Aged; Minocycline; Mutation; Paronychia; Pyridines; Severity of Illness Index; Thiazoles

Topics: Amphotericin B; Animals; Animals, Newborn; Antifungal Agents; Diagnosis, Differential; Diarrhea; Drug Therapy, Combination; Female; Horse Diseases; Horses; Lung Diseases, Fungal; Minocycline; Paecilomyces

Emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) strains that also exhibit resistance to tigecycline and colistin have become a major clinical concern, as these two agents are the last-resort antibiotics used for treatment of CRKP infections. A leukemia patient infected with CRKP was subjected to follow-up analysis of variation in phenotypic and genotypic characteristics of CRKP strains isolated from various specimens at different stages of treatment over a period of 3 years. Our data showed that (1) carbapenem treatment led to the emergence of CRKP in the gastrointestinal (GI) tract of the patient, which subsequently caused infections at other body sites as well as septicemia; (2) treatment with tigecycline led to the emergence of tigecycline-resistant CRKP, possibly through induction of the expression of a variant tet(A) gene located in a conjugative plasmid; (3) colistin treatment was effective in clearing CRKP from the bloodstream but led to the emergence of mcr-1-positive Enterobacteriaceae strains as well as colistin-resistant CRKP in the GI tract due to inactivation of the mgrB gene; and (4) tigecycline- and colistin-resistant CRKP could persist in the human GI tract for a prolonged period even without antibiotic selection pressure. In conclusion, clinical CRKP strains carrying a conjugative plasmid that harbors the bla

Topics: Adult; Antifungal Agents; Antineoplastic Combined Chemotherapy Protocols; Carbapenems; Caspofungin; Colistin; Diarrhea; Drug Resistance, Bacterial; Echinocandins; Feces; Gastrointestinal Tract; Humans; Klebsiella Infections; Klebsiella pneumoniae; Leukemia, Monocytic, Acute; Lipopeptides; Male; Microbial Sensitivity Tests; Minocycline; Tigecycline; Treatment Outcome

Topics: Aged, 80 and over; Anti-Bacterial Agents; Clostridioides difficile; Clostridium Infections; Diarrhea; Female; Humans; Minocycline; Salvage Therapy; Tigecycline; Treatment Outcome

We report the first case of anaphylaxis to oral vancomycin in a cystic fibrosis patient with severe and relapsing Clostridium difficile infection (CDI) refractory to metronidazole. The patient's colitis has been successfully treated with a combination of intravenous metronidazole and tigecycline.

Topics: Administration, Oral; Adult; Anaphylaxis; Anti-Bacterial Agents; Clostridioides difficile; Clostridium Infections; Cystic Fibrosis; Diarrhea; Enterocolitis, Pseudomembranous; Humans; Male; Metronidazole; Minocycline; Severity of Illness Index; Tigecycline; Vancomycin

C. jejuni as well as some hippurate-negative Campylobacter species and related diarrheagenic organisms, are the leading cause of gastroenteritis in our environment all throughout the year. The aim of the present study was to determine the sensitivity of hippurate-negative Campylobacter and Helicobacter pullorum strains isolated from the stools of patients with diarrhea. We tested 39 Campylobacter coli, two C. lari and five Helicobacter pullorum strains identified by mass spectrometry analysis. The sensitivity to amoxicillin-clavulanic acid, erytrhomycin, azithromycin, gentamicin, ciprofloxacin, levofloxacin, tetracycline, tigecycline and chloramphenicol was tested by E-test. Most hippurate-negative Campylobacter and H. pullorum isolates studied showed high resistance to tetracycline and to the two fluorquinolones tested. On the other side, all strains were sensitive to amoxicillin-clavulanic acid, tigecycline and chloramphenicol, while most of them were sensitive to both macrolides tested and to gentamicin.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Campylobacter; Chloramphenicol; Diarrhea; Drug Resistance, Bacterial; Feces; Fluoroquinolones; Gentamicins; Helicobacter; Hippurates; Humans; Microbial Sensitivity Tests; Minocycline; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; Tetracycline Resistance; Tigecycline

Topics: Anti-Bacterial Agents; Clostridioides difficile; Diarrhea; Enterocolitis, Pseudomembranous; Female; Humans; Metronidazole; Microbial Sensitivity Tests; Middle Aged; Minocycline; Tigecycline

Erlotinib (Tarceva) is an epidermal growth factor receptor (EGFR) inhibitor, a member of a new group of molecular targeted drugs that combine high efficacy against tumours with less, often self-limiting, toxicity, compared with traditional chemotherapeutics. It is used for treatment of solid-organ tumours, especially as second- or third-line therapy for non-small-cell lung cancer. Dose-related cutaneous side-effects and diarrhoea may be a significant obstacle to treatment compliance. We present two cases with long-lasting acneiform eruptions, complicated by significant impetiginization, resulting in hospitalization in one case. The other patient suffered from sleep-disturbing, itching crusts on the scalp. As the use of EGFR inhibitors is increasing, clinicians should be aware of their side-effects. Early and timely dermatological intervention may diminish adverse events for patients treated with these agents and improve quality of life.

Topics: Aged; Anti-Bacterial Agents; Diarrhea; Dose-Response Relationship, Drug; Drug Eruptions; Emollients; Erlotinib Hydrochloride; Humans; Male; Middle Aged; Minocycline; Protein Kinase Inhibitors; Pruritus; Quinazolines

Topics: Animals; Anti-Bacterial Agents; Asia, Eastern; Bacteria; Cholera; Diarrhea; Doxycycline; Drug Resistance, Microbial; Gonorrhea; Humans; Infection Control; Male; Minocycline; Mucous Membrane; R Factors; Tetracycline; United States

Topics: Adult; Aged; Bacterial Infections; Diarrhea; Erythromycin; Female; Fever; Headache; Humans; Legionnaires' Disease; Male; Middle Aged; Minocycline; United States

Topics: Anti-Bacterial Agents; Carrier State; Colitis; Diarrhea; Humans; Lincomycin; Minocycline