minocycline and Kidney-Failure--Chronic

A 73-year-old man on hemodialysis with a tunneled central venous catheter presented to the emergency room with a fever and severe back pain.. Physical examination, laboratory investigations, chest radiography, lumbar spine radiography, renal ultrasound, lumbosacral spine MRI and transthoracic echocardiography.. Spondylodiscitis as a result of methicillin-sensitive Staphylococcus aureus bacteremia.. Antibiotic therapy with intravenous cefazolin for 6 weeks and oral minocycline for 2 weeks.

Topics: Aged; Anti-Bacterial Agents; Bacteremia; Catheterization, Central Venous; Catheters, Indwelling; Cefazolin; Discitis; Humans; Kidney Failure, Chronic; Magnetic Resonance Imaging; Male; Minocycline; Staphylococcal Infections

Doxycycline and minocycline are second-generation tetracyclines. They are readily absorbed, distributed throughout the organism as a function of their lipophilicity and eliminated in both the urine and the faeces. The influence of age, renal disease, malnutrition and hyperlipidaemia is reviewed, together with the main pharmacokinetic interactions.

Topics: Adolescent; Adult; Age Factors; Aged; Doxycycline; Drug Interactions; Female; Humans; Kidney Failure, Chronic; Male; Minocycline; Pregnancy; Sex Factors; Tetracyclines; Tissue Distribution

Topics: Clinical Trials as Topic; Half-Life; Humans; Kidney Failure, Chronic; Minocycline; Renal Dialysis; Tetracycline

Topics: Arthritis, Infectious; Arthritis, Rheumatoid; Denosumab; Drug Therapy, Combination; Female; Humans; Hyperpigmentation; Kidney Failure, Chronic; Melanosis; Middle Aged; Minocycline; Prednisone

A 74-year-old female patient with end-stage renal disease, undergoing periodic hemodialysis, was hospitalized due to infection by multidrug-resistant Acinetobacter baumannii after hip replacement surgery. She was treated with tigecycline, a glycylcycline agent. Subsequently she developed coagulation disorders as substantiated by increased international normalized ratio (INR), prolonged partial thromboplastin time (aPTT), and severe hypofibrinogenemia, followed by transaminasemia, cholestasis, and anemia. Ultrasonography and computed tomography revealed no underlying pathological entities. Tigecycline was discontinued and the patient underwent daily hemodialysis and received multiple fresh frozen plasma transfusions. Additionally, she was treated with colistin. Her clinical and laboratory status improved. We suggest that patients treated with tigecycline should be monitored for changes in INR, aPTT, and fibrinogen levels to avoid severe, life-threatening coagulation disturbances.

Topics: Acinetobacter baumannii; Acinetobacter Infections; Aged; Anti-Bacterial Agents; Blood Coagulation Disorders; Colistin; Drug Resistance, Multiple, Bacterial; Female; Humans; International Normalized Ratio; Kidney Failure, Chronic; Minocycline; Partial Thromboplastin Time; Renal Dialysis; Tigecycline

Acinetobacter baumannii are emerging as the causal agents of healthcare-associated infections. We describe arenal transplant recipient who developed bacteremia caused by multiresistant A. baumannii, which received a combination of tigecycline, colistin, and meropenem in continuous infusion. The clinical outcome was favorable. In this article we made a molecular study of this multiresistant strain. Our analysis reveals the presence of abla-OXA-72 gene,a class D of oxacillinase belonging to bla-OXA-40-like group,which constitutes the most disseminated familiy of carbapenemases in Spain. Thus, we found different susceptibility patterns of A. baumannii when we used different Mueller-Hinton agars with different manganese concentrations. Lastly, we explain the combination of these three antibiotics administered to increase microbiologic and pharmacodynamic yield.

Topics: Acinetobacter baumannii; Acinetobacter Infections; Aged; Anti-Bacterial Agents; Colistin; Drug Combinations; Drug Resistance, Multiple, Bacterial; Female; Humans; Kidney Failure, Chronic; Kidney Transplantation; Meropenem; Microbial Sensitivity Tests; Minocycline; Reverse Transcriptase Polymerase Chain Reaction; Thienamycins; Tigecycline

A 76-year-old man who was admitted to the hospital because of chronic renal insufficiency and chronic hepatitis died of Corynebacterium group JK pneumonia, after showing a slight improvement by treatment of Staphylococcus aureus with sulbactam/cefoperazone and minocycline. Transtracheal aspiration (TTA) just before his death revealed numerous gram-positive bacilli phagocytized by many neutrophils and more than 10(8) colony forming units (CFU)/ml of Corynebacterium group JK. A drug susceptibility test showed Corynebacterium group JK was resistant to many antibiotics, with the exception of vancomycin and amikacin.

Topics: Aged; Cefoperazone; Corynebacterium; Corynebacterium Infections; Disease Susceptibility; Drug Resistance, Microbial; Drug Therapy, Combination; Humans; Immunocompromised Host; Kidney Failure, Chronic; Male; Minocycline; Opportunistic Infections; Pneumonia; Pneumonia, Staphylococcal; Sulbactam

Topics: Administration, Oral; Adolescent; Adult; Drug Evaluation; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Minocycline; Renal Dialysis; Respiratory Tract Infections; Tetracyclines; Urinary Tract Infections

Topics: Adult; Doxycycline; Female; Glomerular Filtration Rate; Half-Life; Humans; Kidney Failure, Chronic; Kinetics; Male; Middle Aged; Minocycline; Renal Dialysis; Tetracyclines

The in vitro activity of doxycycline and minocycline (Klinomycin) was determined by serial dilution test in 100 strains of E. coli, 101 strains of enterobacter, 91 tetracycline-sensitive and 52 tetracycline-resistant strains of staphylococci. Only staphylococci were more sensitive against minocycline than against doxycycline whereas other species showed nearly the same sensitivity against both antibiotics. After i.v. infusion of 200 mg minocycline (during 1 h) mean serum levels fell from 3.5 mug/ml to 0.6 mug/ml (after 24 h). Half-life was calculated as 15.7 h, urine recovery as 5.9%. After oral application of 200 mg minocycline serum level peaks were 2.7 mug/ml, serum levels after 24 h 0.7 mug/ml. At repeated administrations daily dosage of 100 mg was too low of 200 mg sufficient to obtain the same serum levels as after the initial dose of 200 mg. CSF levels after oral administration of 0.4 g minocycline were 0.74 +/- 0.09 mug/ml (in serum at the same time 2.2 +/- 0.2 mug/ml). Half-life of minocycline in chronic renal failure (7 adult patients) was not prolonged (15--20 h). Minocycline is especially suitable for treatment of infections of unknown bacterial origin (including such caused by staphylococci). I.v. infusion is indicated only in unconscious or vomiting patients.

Topics: Administration, Oral; Adult; Doxycycline; Enterobacteriaceae; Escherichia coli; Humans; Infusions, Parenteral; Kidney Failure, Chronic; Kinetics; Microbial Sensitivity Tests; Minocycline; Staphylococcus aureus; Tetracycline; Tetracyclines

The pharmacokinetics of minocycline have been studied after single intravenous infusions and repeated oral doses to human subjects with varying degrees of renal impairment. There was no evidence of reduced drug clearance with reduced renal function after intravenous doses although there appeared to be an increase in the tissue distribution of antibiotic in the body in uremia. After identical multiple oral dosage regimens serum levels of antibiotic were comparable in normal and mildly uremic subjects. There was no evidence of renal toxicity in normal or uremic subjects with the repeated dosage regimen used.

Topics: Administration, Oral; Adult; Aged; Humans; Infusions, Parenteral; Kidney Failure, Chronic; Kinetics; Male; Middle Aged; Minocycline; Models, Biological; Tetracyclines; Time Factors

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