minocycline and Infections

To assess the efficacy and safety of tigecycline in comparison with other antimicrobial treatments for infectious diseases.. Databases of PubMed, Embase and the Cochrane Library were searched through Feb. 2015. The reference lists of the initially identified articles and systemic review articles were manually searched. Randomized controlled trials assessing tigecycline and other antibiotics for infectious diseases in adult patients were included.. Fifteen RCTs including 7689 cases were identified. We found that tigecycline was not as effective as the comparator agents for clinical treatment success (for the clinically evaluable population, odds ratio [OR] = 0.83, 95% confidence interval [CI] = (0.73, 0.96), P=0.01; for the clinically modified intent-to-treat (mITT) population, OR = 0.81, 95% CI = (0.72, 0.92), P=0.001). There was no significant difference in microbiological treatment success with lower eradication rate in tigecycline versus comparators (for the microbiologically evaluable population, OR = 0.94, 95% CI = (0.77, 1.16), P=0.56; for the microbiological mITT populations, OR = 0.91, 95% CI = (0.74, 1.11), P=0.35). Adverse events and all-cause mortality were more common in the tigecycline group.. Tigecycline is not as effective as other antibiotics with relatively more frequency of adverse events and higher mortality rate.

Topics: Adult; Anti-Bacterial Agents; Communicable Diseases; Humans; Infections; Minocycline; Randomized Controlled Trials as Topic; Tigecycline

Tigecycline is the first of a new class of antibiotics, the glycylcyclines, with properties which can overcome many common resistance mechanisms, making it appropriate for treatment of many serious and life-threatening infections for which other antibiotics are no longer appropriate. its wide antibacterial spectrum includes most methicillin-resistant staphylococci, vancomycin-resistant enterococci, ESBL-producing and other multi-resistant Gram-negative bacteria such as Acinetobacter and Stenotrophomonas spp. it is also active against anaerobes and atypical pathogens. Tigecycline is available only as parenteral formulation. it has a high volume of distribution (>10 L/kg) and long half-life (36 h). It is approved in the USA and europe for treatment of complicated skin and soft tissue infections and complicated communityacquired intra-abdominal infections. Phase II studies for treatment of community- and nosocomial-acquired pneumonia and sepsis due to multidrug resistant pathogens are ongoing.

Topics: Anti-Bacterial Agents; Clinical Trials as Topic; Community-Acquired Infections; Digestive System Diseases; Humans; Infections; Minocycline; Soft Tissue Infections; Tigecycline

This article examines and discusses some of the most pertinent recent literature on the new glycylcycline antibiotic, tigecycline, in relation to its use for treatment of intraabdominal infections.

Topics: Anti-Bacterial Agents; Clinical Trials as Topic; Digestive System Diseases; Humans; Infections; Minocycline; Tigecycline

Tigecycline is a new glycyclcycline antimicrobial recently approved for use in the USA, Europe and elsewhere. While related to the tetracyclines, tigecycline overcomes many of the mechanisms responsible for resistance to this class. It demonstrates favourable in vitro potency against a variety of aerobic and anaerobic Gram-positive and Gram-negative pathogens, including those frequently demonstrating resistance to multiple classes of antimicrobials. This includes methicillin-resistant Staphylococcus aureus, penicillin-resistant S. pneumoniae, vancomycin-resistant enterococci, Acinetobacter baumannii, beta-lactamase producing strains of Haemophilis influenzae and Moraxella catarrhalis, and extended-spectrum beta-lactamase producing strains of Escherichia coli and Klebsiella pneumoniae. In contrast, minimum inhibitory concentrations for Pseudomonas and Proteus spp. are markedly elevated. Tigecycline is administered parenterally twice daily. Randomised, controlled trials have demonstrated that tigecycline is non-inferior to the comparators for the treatment of complicated skin and skin structure infections, as well as complicated intra-abdominal infections. The most frequent and problematic side effect associated with its administration to date has been nausea and/or vomiting.

Topics: Anti-Infective Agents; Drug Costs; Humans; Infections; Minocycline; Tigecycline

Because of its intracellular mechanism of activity, excellent safety profile, and low cost, doxycycline is one of the most extensively used antibiotics in the world, and its use will increase as new applications are found. One of its most important uses is in treatment of bacterial community-acquired pneumonias, but it is also useful against atypical pneumonias and sexually transmitted disease. As zoonotic infections continue to increase around the world, doxycycline will occupy an increasingly prominent place. Minocycline shares doxycycline's favorable attributes and also has tissue-penetration characteristics that are important when therapeutic alternatives are few, as in MRSA. TMP-SMX is widely used to treat urinary and respiratory tract infections and for prophylaxis and treatment of P carinii infection. As the AIDS epidemic continues, its use will continue to grow, because it is also effective against other pathogens associated with AIDS. TMP-SMX is relatively underused for treating gram-negative bacteremias, especially nosocomial infections caused by nonaeruginosa pseudomonads. Metronidazole is a cost-effective antianaerobic component in treatment of intra-abdominal and pelvic infections, especially when it is combined with a once-a-day antibiotic.

Topics: Anti-Bacterial Agents; Anti-Infective Agents; Cost-Benefit Analysis; Doxycycline; Humans; Infections; Metronidazole; Minocycline; Trimethoprim, Sulfamethoxazole Drug Combination

Only few data are available on the efficacy of tigecycline in critically ill patients.. This prospective, multicenter, non-interventional study investigated the efficacy and safety of tigecycline in hospitalized, severely ill patients with complicated intra-abdominal infections (cIAI) and/or complicated skin and soft tissue infections (cSSTI). Documentation included diagnosis, clinical findings, Acute Physiology and Chronic Health Evaluation II score, laboratory assessments, surgery, clinical outcomes, and adverse events.. Six hundred and fifty-six patients (mean Acute Physiology and Chronic Health Evaluation II score 19.1) with cIAI (41%), cSSTI (16%), multiple infection sites (13%) and/or other severe infections (31%) received tigecycline - 51% as monotherapy - due to failure of previous antibiotics (55%) or since resistant pathogens were suspected or proven (45%); clinical cure/improvement rates were 75, 82, 76 and 67% for cIAI, cSSTI, other severe infections and multiple infection sites, respectively. Drug-related adverse events occurred in 6.7% of patients.. The efficacy and safety of tigecycline was demonstrated in a population of severely ill patients with complicated infections.

Topics: Aged; Anti-Bacterial Agents; Escherichia coli; Female; Germany; Humans; Infections; Male; Middle Aged; Minocycline; Prospective Studies; Severity of Illness Index; Soft Tissue Infections; Staphylococcal Skin Infections; Staphylococcus aureus; Tigecycline; Treatment Outcome

Topics: Animals; Clinical Trials as Topic; Demeclocycline; Dogs; Dose-Response Relationship, Drug; Humans; Infections; Lethal Dose 50; Mice; Microbial Sensitivity Tests; Minocycline; Rats; Tetracycline

Infection and inflammation are common complications that seriously affect the functionality and longevity of implanted medical implants. Systemic administration of antibiotics and anti-inflammatory drugs often cannot achieve sufficient local concentration to be effective, and elicits serious side effects. Local delivery of therapeutics from drug-eluting coatings presents a promising solution. However, hydrophobic and thick coatings are commonly used to ensure sufficient drug loading and sustained release, which may limit tissue integration and tissue device communications. A calcium-mediated drug delivery mechanism was developed and characterized in this study. This novel mechanism allows controlled, sustained release of minocycline, an effective antibiotic and anti-inflammatory drug, from nanoscale thin hydrophilic polyelectrolyte multilayers for over 35 days at physiologically relevant concentrations. pH-responsive minocycline release was observed as the chelation between minocycline and Ca(2+) is less stable at acidic pH, enabling 'smart' drug delivery in response to infection and/or inflammation-induced tissue acidosis. The release kinetics of minocycline can be controlled by varying initial loading, Ca(2+) concentration, and Ca(2+) incorporation into different layers, enabling facile development of implant coatings with versatile release kinetics. This drug delivery platform can potentially be used for releasing any drug that has high Ca(2+) binding affinity, enabling its use in a variety of biomedical applications.

Topics: Anti-Bacterial Agents; Calcium; Drug Delivery Systems; Humans; Hydrophobic and Hydrophilic Interactions; Infections; Inflammation; Minocycline; Prostheses and Implants

This prospective observational study aimed at describing prescription patterns of tigecycline and patient outcomes in 26 French intensive care units (ICU).. Data of consecutive cases of adult patients treated with tigecycline were collected from the initiation until 7 days after the end of treatment. Response to treatment was classified as success, failure or undetermined and analyses were presented according to severity (SOFA score <7 or ≥7). Survival was recorded at 28 days.. A total of 156 patients were included (64% male, age 60 ± 15 years). At inclusion, 53% had a SOFA score ≥7; 93% had received prior anti-infective agents. Tigecycline was given as first-line treatment in 47% of patients, mostly in combination (67%), for intra-abdominal (IAI 56%), skin and soft tissue (SSTI 19%) or other infections. A total of 76% of the treated infections were hospital-acquired. Bacteraemia was reported in 12% of patients. Median treatment duration was 9 days. Tigecycline was prematurely stopped in 42% patients. The global success rate was 60% at the end of treatment, and significantly higher with treatment duration more than 9 days (76 vs. 47%, P < 0.001). Success rate was 65% for patients alive at the end of treatment. Success rates tended to decrease with illness severity, immunosuppression, bacteraemia and obesity. Survival rate at day 28 was 85% in the whole cohort and significantly higher in the less severely ill patients (P < 0.001).. Tigecycline success rates appear comparable to those reported in clinical studies in ICU with severe infections. Tigecycline could be an alternative in ICU patients.

Topics: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacteremia; Critical Illness; Cross Infection; Drug Therapy, Combination; Female; France; Hospital Mortality; Humans; Immunocompromised Host; Infections; Intensive Care Units; Male; Middle Aged; Minocycline; Multivariate Analysis; Obesity; Patient Outcome Assessment; Prospective Studies; Severity of Illness Index; Tigecycline; Young Adult

Topics: Anti-Bacterial Agents; Critical Illness; Female; Hospital Mortality; Humans; Infections; Male; Minocycline; Tigecycline

Topics: Adult; Dapsone; Diagnosis, Differential; Drug Therapy, Combination; Humans; Immunologic Deficiency Syndromes; Infections; Leishmaniasis; Leprostatic Agents; Leprosy, Multibacillary; Male; Minocycline; Mycobacterium leprae; Ofloxacin; Palate; Prednisone; Rifampin; Strongyloidiasis; Treatment Outcome

Topics: Anti-Bacterial Agents; Chemistry, Pharmaceutical; Drug Approval; Humans; Infections; Injections, Intravenous; Meta-Analysis as Topic; Minocycline; Molecular Structure; Technology, Pharmaceutical; Tigecycline

Topics: Anti-Bacterial Agents; Arthritis, Rheumatoid; Humans; Infections; Minocycline

Topics: Adolescent; Adult; Aged; Biological Assay; Doxycycline; Female; Humans; Infections; Male; Middle Aged; Minocycline; Tetracycline

Topics: Adult; Aged; Creatinine; Humans; Infections; Kidney Failure, Chronic; Male; Middle Aged; Minocycline; Tetracycline; Urea; Uremia