minocycline and Postoperative-Complications

 Primary spontaneous pneumothorax (PSP) and its high recurrence rate pose a therapeutic challenge to both patients and their managing surgeons. Mechanical or chemical pleurodesis can be used to prevent recurrence, but the optimal treatment often remains a matter of debate. This meta-analysis aims to compare the outcomes between mechanical and chemical pleurodesis following bullectomy for PSP..  Studies published up to 2019 were searched from Medline, Embase, Google Scholar, and Cochrane databases. A meta-analysis of randomized controlled trials (RCTs) and observational cohort studies (OCSs) comparing outcomes between mechanical and chemical pleurodesis for PSP was performed..  Seven studies (one RCT and six OCSs) were included, comprising 1,032 cases of mechanical (799 abrasions, 202 pleurectomies, and 31 unspecified abrasions/pleurectomies/both), and 901 cases of chemical (643 talc, 69 minocycline, and 189 unspecified talc/kaolin) pleurodesis. The recurrence rate of pneumothorax after chemical pleurodesis (1.2%) was significantly lower than mechanical pleurodesis (4.0%) (pooled odds ratio [OR] = 3.00; 95% confidence interval [CI] = 1.59-5.67;.  Chemical pleurodesis is superior to mechanical pleurodesis following bullectomy for PSP in reducing hospital stay and recurrence rate. However, more RCTs with longer follow-up are necessary to demonstrate the benefit of chemical pleurodesis for PSP.

Topics: Female; Humans; Length of Stay; Male; Minocycline; Operative Time; Pleurodesis; Pneumonectomy; Pneumothorax; Postoperative Complications; Secondary Prevention; Talc

We report the case of a 28-year-old man with a septic forearm non-union treated with minocycline for 3 months. At the time of reconstructive surgery, the radius and ulna were entirely black. Surgical debridement until bleeding of both bone extremities resulted in a 5-cm defect that was filled with a cement spacer. Histology confirmed poorly vascularized bone with focal areas of acute inflammatory infiltrate at the non-union sites (highly suggestive of infection) and normal structure of the remaining diaphyseal bones, although black in color. Reconstruction with free vascularized fibula transfer was successful leading to complete bone healing. An incidental finding of minocycline-induced black bone discoloration should not change the surgeon's decision because there is no evidence of adverse effects on bone healing in the literature. Surgery can be performed safely at sites of minocycline-induced black bone pigmentation.

Topics: Adult; Anti-Bacterial Agents; Fracture Fixation, Intramedullary; Fractures, Ununited; Humans; Male; Minocycline; Pigmentation Disorders; Postoperative Complications; Radius; Radius Fractures; Reoperation; Surgical Wound Infection; Ulna; Ulna Fractures

Opioid treatment of pain is generally safe with 0.5% or less events from respiratory depression. However, fatalities are regularly reported. The only treatment currently available to reverse opioid respiratory depression is by naloxone infusion. The efficacy of naloxone depends on its own pharmacological characteristics and on those (including receptor kinetics) of the opioid that needs reversal. Short elimination of naloxone and biophase equilibration half-lives and rapid receptor kinetics complicates reversal of high-affinity opioids. An opioid with high receptor affinity will require greater naloxone concentrations and/or a continuous infusion before reversal sets in compared with an opioid with lower receptor affinity. The clinical approach to severe opioid-induced respiratory depression is to titrate naloxone to effect and continue treatment by continuous infusion until chances for renarcotization have diminished. New approaches to prevent opioid respiratory depression without affecting analgesia have led to the experimental application of serotinine agonists, ampakines, and the antibiotic minocycline.

Topics: Buprenorphine; Humans; Minocycline; Naloxone; Narcotic Antagonists; Postoperative Complications; Respiratory Insufficiency; Serotonin Agents

Duration of intravenous (IV) treatment, surgical/radiologic interventions for infection control, and hospital length of stay (LOS) are important cost considerations in complicated intra-abdominal infections (cIAIs).. Data were pooled from two multinational, double-blind studies conducted in hospitalized adults with cIAIs who were randomized (1:1) to receive tigecycline (100 mg IV initial dose then 50 mg IV every 12 h) or imipenem-cilastatin (500 mg IV every 6 h) for 5 to 14 days in order to assess tigecycline safety and efficacy. This report focuses on developing predictors of cure and health care resource utilization, including the need for repeat surgical/radiologic interventions, duration of IV antibiotic therapy, and hospital LOS. Multiple regression models were applied for each of the above outcomes, incorporating both baseline and on-treatment potential covariates. Logistic modeling was used for categorical outcomes (cure; repeat surgical/radiologic interventions) and least squares modeling for continuous outcomes (duration of IV antibiotic therapy; LOS). Stepwise selection was used to retain only those predictors found to be significant (p < 0.05) independent risk factors.. The most common causative pathogen was Escherichia coli (63.0%), with 63.3% of the patients exhibiting polymicrobial infections. The most common cIAI diagnosis was complicated appendicitis (51.9%). Lack of clinical cure (+ 6.1 days; p < 0.0001), perforation of the intestine (+3.7 days; p < 0.0001), an Acute Physiology and Chronic Health Evaluation (APACHE) score >15 (+3.1 days; p=0.039), abnormal plasma sodium concentration (+3.7 days; p=0.026), and repeat surgical/radiologic intervention (+2.2 days; p=0.0097) were identified as key risk factors for longer LOS. Inadequate source control was associated with reduced odds of cure, longer IV treatment duration (+1.5 days; p=0.007), and longer LOS. The treatment groups did not differ in terms of LOS, IV treatment duration, or clinical cure.. Tigecycline was similar to imipenem-cilastatin in terms of both efficacy and health resource utilization. Risk factors identified in this study for both outcome measures are offered as support for guiding clinical practice.

Topics: Abdominal Abscess; Aged; Anti-Bacterial Agents; APACHE; Appendicitis; Cilastatin; Cilastatin, Imipenem Drug Combination; Clinical Trials, Phase III as Topic; Digestive System Surgical Procedures; Double-Blind Method; Drug Combinations; Female; Health Resources; Humans; Imipenem; Length of Stay; Male; Middle Aged; Minocycline; Postoperative Complications; Reoperation; Risk Factors; Tigecycline

Seventy patients admitted for abdominal surgery requiring short-term perioperative prophylaxis were randomized to receive minocycline + gentamicin or metronidazole + gentamicin. Thirty patients were considered to be infected at the time of surgery and were treated with the same regimen. In the prophylactic cohort, one patient from each group developed postoperative fever. One patient receiving minocycline developed a wound infection. The overall infection rate was 2.6%. In the treatment cohort, it appeared that the patients receiving metronidazole had more severe underlying diseases than those receiving minocycline. Consequently, more postoperative non-infectious complications were observed in the former. Minocycline + gentamicin appeared at least as effective than metronidazole + gentamicin in preventing postoperative infectious complications associated with abdominal surgery or in treating intra-abdominal infections.

Topics: Abdomen; Adult; Aged; Bacterial Infections; Drug Therapy, Combination; Female; Gentamicins; Humans; Male; Metronidazole; Middle Aged; Minocycline; Postoperative Complications; Premedication; Random Allocation; Tetracyclines

Cyclops syndrome is characterized by a symptomatic extension deficit attributed to impingement of a cyclops lesion within the intercondylar notch. The syndrome is an important cause of reoperation after anterior cruciate ligament reconstruction (ACLR). It has been suggested that remnant-preserving ACLR techniques may predispose to cyclops syndrome, but there is very limited evidence to support this. In general terms, risk factors for cyclops syndrome are not well-understood.. To determine the frequency of and risk factors for reoperation for cyclops syndrome in a large series of patients after ACLR.. Case-control study; Level of evidence, 3.. A retrospective analysis of prospectively collected data was performed, including all patients who underwent primary ACLR between January 2011 to December 2017. Patients undergoing major concomitant procedures were excluded. Demographic data, intraoperative findings (including the size of preserved remnants), and postoperative outcomes were recorded. Those patients who underwent reoperation for cyclops syndrome were identified, and potential risk factors were evaluated in multivariate analysis.. A total of 3633 patients were included in the study, among whom 65 (1.8%) underwent reoperation for cyclops syndrome. Multivariate analysis demonstrated that preservation of large remnants did not predispose to cyclops lesions (odds ratio [OR], 1.11; 95% CI, 0.63-1.93). The most important risk factor was extension deficit in the early postoperative period. If present at 3 weeks postoperatively, it was associated with a >2-fold increased risk of cyclops syndrome (OR, 2.302; 95% CI, 1.268-4.239;. Failure to regain full extension in the early postoperative period was the only significant risk factor for cyclops syndrome after ACLR in a large cohort of patients. Other previously hypothesized risk factors, such as preservation of a large anterior cruciate ligament remnant, did not predispose to the development of this debilitating postoperative complication.

Topics: Anterior Cruciate Ligament; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Case-Control Studies; Factor Analysis, Statistical; Humans; Knee Joint; Minocycline; Plastic Surgery Procedures; Postoperative Complications; Postoperative Period; Range of Motion, Articular; Recovery of Function; Retrospective Studies; Risk Factors; Treatment Outcome

Acute rejection (AR) in renal transplantation is an established risk factor for reduced allograft survival. Molecules with regulatory control among immune pathways of AR that are inadequately suppressed, despite standard-of-care immunosuppression, could serve as important targets for therapeutic manipulation to prevent rejection. Here, an integrative, network-based computational strategy incorporating gene expression and genotype data of human renal allograft biopsy tissue was applied, to identify the master regulators - the key driver genes (KDGs) - within dysregulated AR pathways. A 982-meta-gene signature with differential expression in AR versus non-AR was identified from a meta-analysis of microarray data from 735 human kidney allograft biopsy samples across 7 data sets. Fourteen KDGs were derived from this signature. Interrogation of 2 publicly available databases identified compounds with predicted efficacy against individual KDGs or a key driver-based gene set, respectively, which could be repurposed for AR prevention. Minocycline, a tetracycline antibiotic, was chosen for experimental validation in a murine cardiac allograft model of AR. Minocycline attenuated the inflammatory profile of AR compared with controls and when coadministered with immunosuppression prolonged graft survival. This study demonstrates that a network-based strategy, using expression and genotype data to predict KDGs, assists target prioritization for therapeutics in renal allograft rejection.

Topics: Animals; Anti-Bacterial Agents; Biomarkers; Gene Expression Profiling; Gene Regulatory Networks; Graft Rejection; Graft Survival; Heart Transplantation; Humans; Kidney Transplantation; Male; Mice; Mice, Inbred BALB C; Mice, Inbred C57BL; Minocycline; Postoperative Complications; Prognosis; Risk Factors

Intracranial infections, especially multidrug-resistant (MDR) bacterial meningitis, are one of the most severe complications after craniotomy and may greatly impact patient outcomes.. We report a case of severe MDR Klebsiella pneumonia meningitis after craniotomy that was treated with three different dosages of tigecycline (Pfizer, New York, NY, U.S.A.)via a combined intravenous (IV) and intracerebroventricular (ICV) administration. Here, we discuss the pharmacokinetics (PK) of a combined IV and ICV tigecycline administration for a patient with an intracranial infection after craniotomy.. In the present case, three different dosages of tigecycline were administered: 49 mg IV plus 1 mg ICV q12 h, 45 mg IV plus 5 mg ICV q12 h, 40 mg IV plus 10 mg ICV q12 h. The combined IV and ICV administration might improve CSF tigecycline concentrations, and in this case, the methods of administration were safe and effective.

Topics: Aged; Anti-Bacterial Agents; Craniotomy; Drug Resistance, Multiple, Bacterial; Humans; Infusions, Intravenous; Injections, Intraventricular; Klebsiella Infections; Klebsiella pneumoniae; Male; Meningitis, Bacterial; Microbial Sensitivity Tests; Minocycline; Postoperative Complications; Tigecycline

Objective Postoperative cognitive dysfunction (POCD) is common after surgery in elderly patients and is associated with high morbidity. The molecular mechanisms responsible for POCD are unknown. Minocycline, an inhibitor of microglial activation, may be useful in treating and preventing POCD. We explored whether minocycline can inhibit microglial activation and prevent POCD in aged rats as a surgery model. Methods Rats aged 18 to 20 months were randomly allocated to the following groups: naïve, abdominal surgery alone, or minocycline injection before abdominal surgery. Hippocampal cytokine mRNA levels were measured at 3 hours, 1 day, 3 days, and 7 days after surgery, and microglial activation was measured at 3 hours and 7 days after surgery. Memory was assessed using the Morris water maze test. Results Surgery resulted in severe cognitive impairment in aged rats and induced a significant neuroinflammatory response and microglial activation. The use of minocycline can prevent microglial activation after surgery, but delayed microglial activation may occur. The use of minocycline may further impair memory after surgery. Conclusion Minocycline can restrain microglial activation and restrict the inflammatory response in the hippocampus early after surgery, but it may induce delayed microglial activation and cannot prevent POCD in aged rats.

Topics: Aging; Animals; Cognitive Dysfunction; Dose-Response Relationship, Drug; Hippocampus; Interleukin-1beta; Memory, Short-Term; Microglia; Minocycline; Postoperative Complications; Rats, Sprague-Dawley; RNA, Messenger; Tumor Necrosis Factor-alpha

Topics: Aged; Amikacin; Anti-Bacterial Agents; Bacterial Proteins; beta-Lactamases; Ciprofloxacin; Colonic Diseases; Drug Synergism; Drug Therapy, Combination; Enterobacter cloacae; Enterobacteriaceae Infections; Female; Fosfomycin; Hernia, Abdominal; Herniorrhaphy; Humans; Intestinal Fistula; Minocycline; Postoperative Complications; Prosthesis-Related Infections; Soft Tissue Infections; Surgical Mesh; Tigecycline

To study a cohort of patients with intra-abdominal postsurgical infection treated with tigecycline to analyze its effectiveness and mortality related factors.. Prospective study of patients with intra-abdominal postsurgical infection with microbiological isolation and treated with tigecycline.. Out of 103 patients only 61 full fit inclusion criteria. Mean age was 67 year-old and 72% were male. Charlson score was ≥ 3 in 65.5%, being diabetes and colon cancer the most prevalent diseases. Cancer surgery was the most frequent procedure (n=44, 72%) and previous antibiotic administration was present in 43 cases (69%). Pitt score was ≥ 3 in 69% and most prevalent bacteria were Escherichia coli (38 %), Enterococcus spp. (34%; mainly Enterococcus faecium) and Klebsiella pneumoniae together with Enterobacter cloacae (28%). Tigecycline was prescribed alone (17; 28%) or in combination with other antibiotics (44; 72%), mainly meropenem (25; 57%) or amikacin (19, 43%). 11 patients died (18%), all of which suffered extended cancer surgery and isolation of extended-spectrum betalactamase producing Enterobacteriaceae. Factors statistically associated to death in univariate analysis were Charlson score >3, pH <7.3 and leucocyte count >20.000 cells/mm3.. As being a cohort of patients treated with tigecycline, E. faecium isolation was very frequent. Non-fatal evolution was achieved in 82% cases, being tigecycline a potentially good option in the empiric treatment of very severe infections.

Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; Cohort Studies; Drug Resistance, Multiple, Bacterial; Enterobacteriaceae Infections; Female; Humans; Intraabdominal Infections; Male; Middle Aged; Minocycline; Postoperative Complications; Prospective Studies; Risk Factors; Spain; Tigecycline

Although the ultrasonic scalpel is known to avoid inadvertent thermal injury to pulmonary parenchyma owing to its lower tip temperature, there are reports suggesting late onset postoperative alveolar air leakage by using it. Herein, a novel method of preventing postoperative air leakage was developed by using a sustained release system of fibrin glue-minocycline combination. This method ensures that the effect of fibrin glue is followed by the effect of minocycline, which functions as a sustained release formulation. This study demonstrates a simple and effective method of preventing postoperative air leakage, without any increase in the rate of adverse events.

Topics: Anti-Bacterial Agents; Delayed-Action Preparations; Drug Combinations; Fibrin Tissue Adhesive; Humans; Minocycline; Pneumonectomy; Postoperative Complications; Risk Factors; Thoracic Surgery, Video-Assisted; Tissue Adhesives; Treatment Outcome

We report the first case of Mycoplasma hominis periaortic abscess after heart-lung transplantation. The absence of sternal wound infection delayed the diagnosis, but the patient successfully recovered with debridement surgeries and long-term antibiotic therapy. Owing to the difficulty in detection and the intrinsic resistance to beta-lactams, M. hominis infections are prone to being misdiagnosed and undertreated. M. hominis should be suspected in cases where conventional microbiological identification and treatment approaches fail.

Topics: Abscess; Adult; Anti-Bacterial Agents; beta-Lactam Resistance; beta-Lactamases; Bronchoscopy; Cardiomyopathy, Restrictive; Debridement; Dyspnea; Glucocorticoids; Graft Rejection; Heart-Lung Transplantation; Humans; Hypertension, Pulmonary; Levofloxacin; Male; Methylprednisolone; Minocycline; Mycoplasma hominis; Nausea; Plasmapheresis; Postoperative Complications; Respiratory Insufficiency; Sternum; Surgical Wound Infection; Tomography, X-Ray Computed; Young Adult

Non-crosslinked porcine acellular dermal grafts (NCPADG) are currently the mainstay biomaterial for abdominal wall reconstruction (AWR) in complex hernia patients. We report early clinical outcomes using a novel rifampin/minocycline-coated NCPADG for AWR.. A multi-institutional retrospective review was performed of patients who underwent ventral hernia repair using XenMatrix AB Surgical Graft (CR Bard, Inc [Davol]). Patient demographics, hernia and procedure characteristics, and surgical site occurrences/postoperative complications were reviewed up to 6 months after AWR.. Seventy-four patients underwent AWR using XenMatrix AB Surgical Graft. Open AWR was performed in 52 patients (70.3%), and 22 patients (29.7%) underwent laparoscopic VHR. Median hernia size/area was 66.0 cm(2) (range 9.4 to 294.5 cm(2)). Sixteen patients (21.6%) had previous wound infections, and 16 patients (21.6%) had violation of the gastrointestinal tract during hernia repair. The most common locations of NCPADG placement were within the intraperitoneal (32.4%) and onlay (21.6%) positions, respectively. Median hospital length of stay was 4 days. Within 30 days after AWR, 6 (8.1%) patients were readmitted, postoperative seroma formation developed in 4 (5.4%) patients, 1 patient required percutaneous drainage, and surgical site infections developed in 5 (6.8%) patients. At 6 months follow-up, hernia recurrence had developed in 4 (5.4%) patients.. Data suggest that use of a novel rifampin/minocycline-coated NCPADG was associated with a low rate of postoperative surgical site occurrences/postoperative complications during the first 30 days of follow-up in complex AWR patients. In addition, data suggest a low rate of hernia recurrence at 6-month follow-up. Additional study is warranted to determine whether early antimicrobial protection of the device translates into longer-term protection of the repair.

Topics: Abdominal Wall; Acellular Dermis; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Drug Combinations; Female; Follow-Up Studies; Hernia, Ventral; Herniorrhaphy; Humans; Male; Middle Aged; Minocycline; Postoperative Complications; Recurrence; Retrospective Studies; Rifampin; Treatment Outcome

We describe an 11-year-old boy with nemaline myopathy who developed tension pneumothorax while undergoing noninvasive positive-pressure ventilation (NIPPV). The patient developed a persistent air leak after pleurodesis with minocycline hydrochloride and lowering of the NIPPV inspiratory pressure. He required additional respiratory support without the high airway pressures that may aggravate pneumothorax. We provided adequate respiratory support without increasing the positive airway pressure using biphasic cuirass ventilation (BCV), which moved the patient's chest wall by negative pressure. The air leak was resolved without any additional treatment. We should provide BCV for patients in whom surgery may have a risk of both extubation failure and postoperative complications before deciding on surgery.

Topics: Airway Extubation; Child; Humans; Male; Minocycline; Myopathies, Nemaline; Pneumothorax; Positive-Pressure Respiration; Postoperative Complications

Anterior Cruciate ligament (ACL) is a typical athletic injury. One of the most frequent complication after ACL reconstruction is reduced range of motion (ROM) due to the impingement on the inter-condylar notch of a fibrous tissue mass, defined as Cyclops Syndrome. We report the case of a 25 years old male, who underwent reconstruction of ACL with Gracilis-semitendinosus (GR-ST) tendons with delayed onset of loss of knee extension seven years after ACL reconstruction. Clinical and magnetic resonance image (MRI) findings were consistent with Cyclops syndrome. The patient underwent arthroscopy in May 2015, which revealed a fixed fibrous nodule impinging on the inter-condylar notch in extension that was treated by mechanical shaving, radiofrequency ablation remodeling inter-condylar notch and releasing of the ACL transplant. After surgery our patient returned to his routine activities after 5 days and started running about 10 days later, without anterior knee pain and without deficit of hyperextension.

Topics: Adult; Anterior Cruciate Ligament; Anterior Cruciate Ligament Injuries; Humans; Knee Injuries; Knee Joint; Male; Minocycline; Postoperative Complications; Range of Motion, Articular

Based on tigecycline linear pharmacokinetic/pharmacodynamics, dose increases have been advocated to maximise activity especially when severe infections with high bacterial load and/or multidrug resistance are suspected. This practice-based observational study explored factors associated with tigecycline administration (100 mg/12h, 200 mg loading dose) in severely ill patients with complicated intra-abdominal infection (cIAI) admitted to four Surgical Critical Care Units (SCCUs).. Medical records of all consecutive adult patients with cIAI and controlled infection source requiring surgery and admission for ≥ 48 h to SCCU were reviewed and divided into patients treated with a regimen including tigecycline (tigecycline group) and those that not (control group). A logistic regression model was performed using "tigecycline administration" (dependent variable) and variables showing differences (p ≤ 0.1) in bivariate analyses (independent variables).. One hundred and twenty one patients were included. In the tigecycline group, higher percentage of patients (vs. controls) presented colon as surgical site (66.7% vs. 41.8%, p = 0.006), nosocomial infection (55.6% vs. 26.9%, p = 0.001), mechanical ventilation (48.1% vs. 28.4%, p = 0.025), chronic renal replacement therapy (40.7% vs. 19.4%, p =0.008), septic shock (72.2% vs. 46.3%, p = 0.004), and higher values of SAPS II (48.0 ± 15.0 vs. 39.6 ± 15.5, p = 0.003), SOFA at admission (7.0 ± 3.3 vs. 5.5 ± 3.7, p = 0.020), lactate-24h (2.5 ± 2.8 vs. 1.6 ± 0.9, p = 0.029) and CRP-72 h (207.4 ± 87.9 vs. 163.7 ± 76.8, p = 0.021). In the multivariate analysis (R2 = 0.187, p < 0.001) nosocomial infection (OR = 7.721; 95%CI = 2.193, 27.179; p = 0.001), colon as infection site (OR = 4.338; 95%CI = 1.432, 13.145; p = 0.009) and CRP-72 h (OR = 1.009 per-unit; 95%CI = 1.002, 1.016; p = 0.012) were associated with tigecycline administration.. In severely ill patients with cIAI, high-dose tigecycline administration was associated with nosocomial origin of cIAI and colon as source infection site.

Topics: Aged; Anti-Bacterial Agents; Critical Care; Critical Illness; Digestive System Surgical Procedures; Female; Humans; Intraabdominal Infections; Male; Middle Aged; Minocycline; Peritonitis; Postoperative Complications; Prospective Studies; Retrospective Studies; Surgical Wound Infection; Tigecycline

A 68-year-old male underwent a right hepatectomy, resection of the biliary convergence, and a left hepatic jejunostomy for a Klatskin tumour. The postoperative course was complicated by biliary abscesses with relapsing bloodstream infections due to Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae (KPC-Kp). A 2-week course of combination antibiotic therapy failed to provide source control and the bacteraemia relapsed. Success was obtained with a regimen of tigecycline 100mg daily for 2 months, followed by tigecycline 50mg daily for 6 months, then 50mg every 48h for 3 months. No side effects were reported.

Topics: Aged; Anti-Bacterial Agents; Bacteremia; Bacterial Proteins; beta-Lactamases; Humans; Klebsiella Infections; Klebsiella pneumoniae; Liver; Male; Minocycline; Postoperative Complications; Tigecycline

Cerebral hyperperfusion (CHP) is a potential complication of superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis for moyamoya disease (MMD), and optimal postoperative management has not yet been established. Minocycline, a neuroprotective antibiotic agent, plays a role in blocking matrix metalloproteinase 9 (MMP-9), which contributes to edema formation and hemorrhagic conversion after cerebral ischemia-reperfusion. Patients with MMD have been shown to have increased serum MMP-9 levels.. To examine the effect of minocycline on the prevention of postoperative CHP after STA-MCA anastomosis for MMD.. N-isopropyl-p-[I]iodoamphetamine single-photon emission computed tomography was performed 1 and 7 days after STA-MCA anastomosis on 109 hemispheres in 86 consecutive patients with MMD (ages, 9-69 years; mean, 37.2 years). Postoperative systolic blood pressure was strictly maintained at lower than 130 mm Hg in all 109 surgeries. The most 60 recent hemispheres were managed by the intraoperative and postoperative intravenous administration of minocycline hydrochloride (200 mg/d). The incidence of focal neurological deterioration (FND) due to CHP was then compared with that in 36 patients undergoing 49 surgeries managed without minocycline.. FND due to CHP was observed in 4 operated hemispheres in patients treated without minocycline (4/49, 8.16%), and in none in the minocycline-treated group (0/60) (P = .0241). Multivariate analysis revealed that minocycline administration (P < .001), surgery on the left hemisphere (P = .031), and a smaller recipient artery diameter (P < .001) significantly correlated with FND due to CHP.. The administration of minocycline with strict blood pressure control may represent secure and effective postoperative management to prevent symptomatic CHP after STA-MCA anastomosis for MMD.

Topics: Adolescent; Adult; Aged; Anastomosis, Surgical; Blood Pressure Determination; Brain; Cerebral Revascularization; Cerebrovascular Disorders; Child; Female; Humans; Male; Middle Aged; Middle Cerebral Artery; Minocycline; Moyamoya Disease; Neuroprotective Agents; Postoperative Care; Postoperative Complications; Radionuclide Imaging; Reperfusion Injury; Temporal Arteries; Young Adult

Tigecycline is a relatively new glycylcycline antimicrobial, active in vitro against a variety of Gram-positive and Gram-negative organisms. In this study we evaluated the outcomes of spondylodiscitis cases treated with tigecycline-including therapies retrospectively.. All adult (age >18 years) cases with a diagnosis of spondylodiscitis, who were treated with a tigecycline-including therapy between 2007 and 2011, were included in the study. The primary efficacy outcome was clinical success with tigecycline at the end of induction, while the secondary efficacy outcome was maintenance of success through 3 months following completion of induction.. A total of eight spondylodiscitis cases fulfilled the study inclusion criteria. All cases had back pain, restricted mobility, magnetic resonance findings associated with spondylodiscitis, and microbiology or pathological findings related to spondylodiscitis. All had post-neurosurgical spondylodiscitis. In five cases, tigecycline was started in accordance with the antibacterial susceptibility results from intervertebral tissue biopsy cultures, whereas in three it was started empirically. All cases had received several different antibacterials with failure before receiving tigecycline. The mean duration of tigecycline treatment was 37±21 days. One case was lost to follow-up after 2 days of tigecycline. Primary and secondary success was achieved in the remaining seven cases.. These limited data suggest that tigecycline may have a role in the treatment of refractory spondylodiscitis cases.

Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacterial Infections; Blood Sedimentation; C-Reactive Protein; Discitis; Disease Management; Female; Follow-Up Studies; Humans; Male; Middle Aged; Minocycline; Neurosurgical Procedures; Postoperative Complications; Retrospective Studies; Tigecycline; Treatment Outcome

Prolonged air leak is the most common complication after thoracoscopic operation for primary spontaneous pneumothorax (PSP), and the role of chemical pleurodesis in treating air leaks remains unclear. This study evaluated the safety and efficacy of chemical pleurodesis with a comparison between minocycline and OK-432.. Between 1994 and 2011, 1083 PSP patients were treated by thoracoscopic operation. After the operation, patients with persistent air leak for 3 days or more were managed by minocycline or OK-432 pleurodesis. The demographic and outcome data for these patients were collected by retrospective chart review.. Seventy-nine patients (7.3%) with prolonged air leak after thoracoscopy underwent minocycline pleurodesis (60 patients) or OK-432 pleurodesis (19 patients) as the primary treatment. The primary success rate was 63% (38/60) for minocycline pleurodesis and 95% (18/19) for OK-432 pleurodesis (p = 0.009). Postpleurodesis pain was common and comparable between the two groups. No major complications were noted after a total of 121 treatments. Patients undergoing primary OK-432 pleurodesis had shorter durations of postpleurodesis chest drainage (mean 8.5 vs. 2.3 days; p < 0.001) and postoperative hospital stay (mean 11.9 vs. 6.8 days; p < 0.001) than those undergoing primary minocycline pleurodesis. After a median follow-up of 16 months, recurrence was noted in one patient in the OK-432 group and none in the minocycline group. Long-term pulmonary function in the two groups was comparable.. Chemical pleurodesis using OK-432 or minocycline is safe and convenient for prolonged air leak after thoracoscopic treatment for PSP. Our experience suggested that OK-432 may be more effective than minocycline in reducing air leak.

Topics: Adult; Female; Humans; Male; Minocycline; Picibanil; Pleurodesis; Pneumothorax; Postoperative Complications; Retrospective Studies; Thoracic Surgery, Video-Assisted

Intra-abdominal infection (IAI) is a frequent complication found in surgical intensive care unit (SICU) and continues to be associated with considerable mortality. Tigecycline, the first-in-class glycylcycline has demonstrated a broad spectrum of activity against a wide range of bacteria commonly found in IAI. This observational retrospective study aimed to describe the experience with tigecycline for serious nosocomial IAI in the SICU. Data were collected from 23 consecutive patients admitted to SICU with serious nococomial IAI who had received empirical treatment with tigecycline. In all cases, IAI was diagnosed via emergency surgery. Severe sepsis was found in 56.5% and 43.5% developed septic shock. Oncological disease was the most common comorbidity (60%). The mean Simplified Acute Physiology Score (SAPS) III within 24 hours from IAI diagnosis was 57.5±14.7, and 87% showed a McCabe score >1 (2 or 3). Escherichia coli was the most common pathogen (43.5%), followed by Bacteroides spp. and Streptococcus spp. (30.4%, respectively). All but one patient received tigecycline in combination (95.7%), particularly with fluconazole (52.2%), followed by piperacillin-tazobactam (43.5%). Empirical antibiotic therapy was considered adequate in 95%. The mean duration of treatment was 8.5±4.5 days. A favorable response was achieved in 78%. Failure of the antibiotic therapy was not observed in any patient. None of the patients discontinued tigecycline due to adverse reactions. SICU mortality was 13%, with no deaths attributable to tigecycline. These findings suggest that tigecycline combination therapy is an effective and well tolerated empirical treatment of serious nosocomial IAI in the SICU.

Topics: Adult; Aged; Anti-Bacterial Agents; Combined Modality Therapy; Comorbidity; Critical Care; Critical Illness; Cross Infection; Drug Evaluation; Drug Resistance, Multiple, Bacterial; Drug Therapy, Combination; Female; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Gram-Positive Bacteria; Gram-Positive Bacterial Infections; Hospital Mortality; Humans; Male; Middle Aged; Minocycline; Neoplasms; Postoperative Complications; Retrospective Studies; Sepsis; Shock, Septic; Tigecycline; Treatment Outcome

Topics: Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacterial Infections; Humans; Male; Minocycline; Penile Prosthesis; Postoperative Complications; Rifampin

Topics: Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacterial Infections; Humans; Male; Minocycline; Penile Prosthesis; Postoperative Complications; Rifampin

Topics: Aged; Anti-Bacterial Agents; Drug Resistance, Bacterial; Enterococcus faecalis; Gram-Positive Bacterial Infections; Humans; Intraabdominal Infections; Male; Microbial Sensitivity Tests; Minocycline; Omeprazole; Postoperative Complications; Tigecycline

Patients who undergo device revision surgery are at higher risk for infection than virgin implant recipients. The revision rate due to virgin implant infection is statistically significantly lower for minocycline/rifampin impregnated than for nonimpregnated inflatable penile prostheses. We determined whether the frequency of infection revision events after device replacement surgery would also be lower for minocycline/rifampin impregnated inflatable penile prostheses.. Patient information forms voluntarily submitted to AMS® after replacement inflatable penile prosthesis implantation between 2001 and 2007 were retrospectively reviewed to compare secondary infection related revision events for antibiotic impregnated vs nonimpregnated implants. Only men who received an inflatable penile prosthesis at a first recorded operation to replace a previously implanted penile prosthesis were included in the study. Life table survival analysis was done between the groups to compare infection related events resulting in a second surgical revision after replacement implantation. Survival function extrapolation was based on parametric analysis using the Weibull distribution model.. On life table survival analysis secondary revision due to infection was significantly less common in the minocycline/rifampin impregnated group than in the nonimpregnated group (log rank p = 0.0252). At up to 6.6 years of followup 2.5% of 9,300 men with vs 3.7% of 1,764 without an impregnated device underwent secondary revision due to infection.. This long-term device survival analysis provides clinical evidence of a significant decrease in infection related secondary revisions using minocycline/rifampin impregnated prostheses vs nonimpregnated inflatable penile prostheses at replacement implant surgery.

Topics: Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacterial Infections; Humans; Male; Middle Aged; Minocycline; Penile Prosthesis; Postoperative Complications; Prosthesis Design; Reoperation; Retrospective Studies; Rifampin; Time Factors; Treatment Outcome

Although some studies suggest that most infections associated with inflatable penile prosthesis implantation develop within year 1 after surgery, device related infections have been reported 5 years after implantation or later and the infection risk with time is not well characterized. We previously reported a statistically significantly lower infection rate for original inflatable penile prostheses impregnated with antibiotic treatment with minocycline and rifampin vs nonimpregnated inflatable penile prostheses at 1-year followup. Long-term data are now available on infection revision after initial implantation of antibiotic impregnated vs nonimpregnated prostheses.. We retrospectively reviewed patient information forms voluntarily filed with the manufacturer after the initial implantation of more than 39,000 inflatable penile prostheses to compare the revision rate due to infection for antibiotic impregnated vs nonimpregnated implants between May 1, 2001 and December 31, 2008. Life table analysis was used to evaluate device survival from revision surgery.. On life table survival analysis initial revision events due to infection were significantly less common in the impregnated vs the nonimpregnated group (log rank p <0.0001). At up to 7.7 years of followup 1.1% of 35,737 vs 2.5% of 3,268 men with impregnated vs nonimpregnated implants underwent initial revision due to infection.. To our knowledge this long-term outcome analysis provides the first substantial clinical evidence of a decrease in costly infection related revision using an antibiotic impregnated inflatable penile prosthesis.

Topics: Anti-Bacterial Agents; Chi-Square Distribution; Cohort Studies; Drug Delivery Systems; Erectile Dysfunction; Follow-Up Studies; Humans; Male; Middle Aged; Minocycline; Penile Prosthesis; Postoperative Complications; Prosthesis Design; Prosthesis Failure; Prosthesis Implantation; Prosthesis-Related Infections; Reference Values; Reoperation; Retrospective Studies; Rifampin; Risk Assessment; Treatment Outcome

Postoperative cognitive dysfunction (POCD) is reported to occur frequently after all types especially cardiac surgery in elderly patients. It can be short-term or long-term and some cases even develop into Alzheimer's disease (AD). Although multi-risk factors associated with POCD have been identified, the etiology and pathophysiological mechanisms of this surgical complication remain elusive. Therefore, developing strategies for preventing or treating POCD is still challenging. However, increasing evidence suggests that central and systemic inflammation triggered by surgery likely plays a fundamental role in POCD developing and progression. Minocycline, a tetracycline derivative with anti-inflammatory properties, has been shown to be effective in treating neuroinflammatory related conditions or neurodegenerative diseases such as AD, Parkinson's disease, Huntington's disease. Considering that inflammation may be a potential factor of POCD and minocycline is effective in improving cognitive dysfunction induced by inflammation, we hypothesize that minocycline may be useful to treat/prevent the POCD development after surgery in elderly patients.

Topics: Aged; Anti-Bacterial Agents; Anti-Inflammatory Agents; Brain Diseases; Cognition Disorders; Humans; Inflammation; Minocycline; Models, Theoretical; Neurodegenerative Diseases; Postoperative Complications; Sepsis; Tetracycline; Treatment Outcome

Post-arthroplasty infections represent a devastating complication of total joint replacement surgery, resulting in multiple reoperations, prolonged antibiotic use, extended disability and worse clinical outcomes. As the number of arthroplasties in the U.S. will exceed 3.8 million surgeries per year by 2030, the number of post-arthroplasty infections is projected to increase to over 266,000 infections annually. The treatment of these infections will exhaust healthcare resources and dramatically increase medical costs.. To evaluate novel preventative therapeutic strategies against post-arthroplasty infections, a mouse model was developed in which a bioluminescent Staphylococcus aureus strain was inoculated into a knee joint containing an orthopaedic implant and advanced in vivo imaging was used to measure the bacterial burden in real-time. Mice inoculated with 5x10(3) and 5x10(4) CFUs developed increased bacterial counts with marked swelling of the affected leg, consistent with an acute joint infection. In contrast, mice inoculated with 5x10(2) CFUs developed a low-grade infection, resembling a more chronic infection. Ex vivo bacterial counts highly correlated with in vivo bioluminescence signals and EGFP-neutrophil fluorescence of LysEGFP mice was used to measure the infection-induced inflammation. Furthermore, biofilm formation on the implants was visualized at 7 and 14 postoperative days by variable-pressure scanning electron microscopy (VP-SEM). Using this model, a minocycline/rifampin-impregnated bioresorbable polymer implant coating was effective in reducing the infection, decreasing inflammation and preventing biofilm formation.. Taken together, this mouse model may represent an alternative pre-clinical screening tool to evaluate novel in vivo therapeutic strategies before studies in larger animals and in human subjects. Furthermore, the antibiotic-polymer implant coating evaluated in this study was clinically effective, suggesting the potential for this strategy as a therapeutic intervention to combat post-arthroplasty infections.

Topics: Animals; Anti-Bacterial Agents; Arthroplasty; Disease Models, Animal; Humans; Joint Diseases; Joints; Male; Mice; Mice, Inbred C57BL; Minocycline; Postoperative Complications; Prostheses and Implants; Rifampin; Staphylococcal Infections; Staphylococcus aureus

Bilophila wadsworthia is a recently recognized nonspore-forming anaerobic Gram-negative rod and is reported to be associated with various surgical infections. In the present study, the isolation rate of B. wadsworthia from surgical specimens and its antimicrobial susceptibilities were examined. Last 5 years, B. wadsworthia was isolated from 46 (5.2%) out of 884 specimens from the surgical abdominal infections. B. wadsworthia was most frequently isolated from secondary peritonitis such as perforated peritonitis, followed by postoperative peritonitis. There is no case of single isolation of B. wadsworthia. The rate of mixed infection with Bacteroides spp. (24.8%) was highest, followed by Escherichia coli (11.6%) and Enterococcus spp. (10.1%). Although B. wadsworthia was highly resistant to many beta-lactam antibiotics, clindamycin showed strongest activities with MIC90 of 1 microg/mL, followed by minocycline and ciprofloxacin with 4micro g/mL, and levofloxacin with 8 microg/mL, respectively.

Topics: Anti-Bacterial Agents; beta-Lactams; Bilophila; Ciprofloxacin; Clindamycin; Digestive System Surgical Procedures; Drug Resistance, Bacterial; Humans; Japan; Levofloxacin; Minocycline; Ofloxacin; Peritonitis; Postoperative Complications; Specimen Handling; Surgical Wound Infection

Postoperative cervical lymphorrhea is a complication uncommonly encountered following neck dissection for which several treatment modalities have been described in the literature. We managed 8 cases of lymphorrhea after neck dissection by injecting Minocycline through a drainage tube. We attempted this procedure for lymph discharge that had continued despite pressure dressing and systemic management with nutritional modification for about 1 week. This treatment rapidly resolved lymph discharge in 6 of the 8 cases. No patient required surgical intervention. Minocycline sclerotherapy has typically been used to treat pleural effusion, ascites, pneumothorax, and other cystic diseases of the liver, pancreas, and kidney. In many cases, this therapy brings rapid resolution. This inefficiency is due to the acidity and toxicity of Minocycline. No major adverse effects have been reported. We believe that Minocycline sclerotherapy is effective for rapidly resolving lymphorrhea following neck dissection and use of this therapy should be attempted before surgical intervention.

Topics: Humans; Lymphatic Diseases; Male; Middle Aged; Minocycline; Neck; Neck Dissection; Postoperative Complications; Sclerotherapy; Treatment Outcome

It has been known that treatments of post-pneumonectomy empyema are difficult. We report a successful case of irrigation for the post-pneumonectomy. The patient was 68-year-old man with advanced lung cancer. He underwent induction chemoradiotherapy following by pneumonectomy of the right side. A few days later after the chest drain was withdrawn, spike fever appeared. Empyema was suspected, so a 28 Fr diameter double lumen chest drain was intubated again. Turbid effusion was discharged through the drain, in which methicillin-resistant staphylococcus aureus (MRSA) was cultured. Irrigation using a lot of saline and acid electrolyzed water started. A month later, irrigator through the drain was looking clear, however, MRSA was cultured so far. After putting minomycine into the irrigator, MRSA died away. This physical and chemical irrigations were effective.

Topics: Adenocarcinoma; Aged; Empyema, Pleural; Humans; Lung Neoplasms; Male; Methicillin Resistance; Minocycline; Pneumonectomy; Postoperative Complications; Staphylococcal Infections; Therapeutic Irrigation

This paper describes an unusual case of florid postoperative pigmentation caused by minocycline which was not diagnosed for some 8 months, causing anxiety and distress to both patient and surgeon.

Topics: Anti-Bacterial Agents; Drug Eruptions; Female; Humans; Middle Aged; Minocycline; Pigmentation Disorders; Postoperative Complications; Varicose Veins

We report herein the case of a woman with bronchopleural fistulas treated with the endobronchial placement of vascular embolization coils. She was referred to our hospital to undergo lavage of a postoperative empyema. She had undergone an air plombage operation for pulmonary tuberculosis 9 years previously. However, bronchopleural fistulas occurred postoperatively and she had to continue the use of a chest drainage tube since then. Lavage of her empyema space with 5kE of OK-432 (Picibanil: Chugai) plus 100 mg minocycline was performed once every 2 weeks for 3 months, and the purulent discharge from the empyema remarkably decreased. Thereafter, the bronchopleural fistulas were occluded endobronchially by the placement of vascular embolization coils. Soon after the procedure, air leakage from the fistulas was stopped and the drainage tube was removed 2 days later. The patient remains well without any additional treatment at 20 months after this treatment. As treatment for empyema with bronchopleural fistulas, it would be worth trying to lavage the empyema space with OK-432 until it is cleaned out and to plug the fistulas by the endobronchial placement of embolization coils, before such radical operations as thoracoplasty and space-filling of the empyema are considered.

Topics: Bronchial Fistula; Bronchoalveolar Lavage; Embolization, Therapeutic; Empyema, Pleural; Female; Fistula; Humans; Middle Aged; Minocycline; Picibanil; Pleural Diseases; Postoperative Complications; Tomography, X-Ray Computed

Susceptibilities to antibiotics were determined in 36 strains of methicillin-resistant Staphylococcus aureus (MRSA) isolated from clinical specimens from 1990 to 1992. Rates of resistance to arbekacin and minocycline were 31% and 53%, respectively. However, all MRSA isolates were susceptible to vancomycin. MRSA was found in 12 out of 35 cases. Three infections caused by MRSA included enterocolitis (3), abscess (5), pneumonia (1), cholangitis (1), peritonitis (1) and catheter related sepsis (1). In two cases patients died with bacteremia within two years after the onset of MRSA infections.

Topics: Aged; Aged, 80 and over; Aminoglycosides; Anti-Bacterial Agents; Dibekacin; Female; Humans; Male; Methicillin Resistance; Microbial Sensitivity Tests; Middle Aged; Minocycline; Postoperative Complications; Staphylococcal Infections; Staphylococcus aureus; Vancomycin

Four cases of postoperative meningitis caused by methicillin-resistant Staphylococcus aureus (MRSA) are reported together with a review of the literature. These 4 cases were treated successfully by intravenous administration of minomycin, fosfomycin, and cefmetazole. Factors associated with the development of meningitis included multiple craniotomies, the presence of ventricular drainage or a ventriculo-peritoneal shunt, and irradiation.

Topics: Adult; Cefmetazole; Drug Therapy, Combination; Fosfomycin; Humans; Injections, Intravenous; Male; Meningitis; Methicillin Resistance; Middle Aged; Minocycline; Postoperative Complications; Staphylococcal Infections; Staphylococcus aureus

Assessment has been made, using MIC values and coagulase types, of 214 strains of Staphylococcus aureus isolated from the lesions of inpatients at the First Surgical Department, Hiroshima University, from 1983 to 1988. The obtained results are summarized below: 1. Frequency of MRSA among all the strains of S. aureus during a period from 1983 to 1987 was higher than 50%. 2. Highly methicillin-resistant strains (MIC of methicillin greater than 100 micrograms/ml) emerged in 1984 and thereafter, showed a trend of increase through 1987. 3. The highly methicillin-resistant strains are of coagulase II type strain and they are considered to be inhospital epidemic strains. 4. Both ofloxacin and minocycline (MINO) showed good activities against highly methicillin-resistant strains, but many resistant strains were resistant to beta-lactam and aminoglycoside agents. Based on the above basic assessment, chemotherapies mainly using MINO were performed on cases of MRSA infections experienced at the First Surgical Department, Hiroshima University in a period from July, 1987, to November, 1988, and the following results were obtained. 1. Drugs used were: single MINO in 2 cases; MINO+imipenem/cilastatin (IPM/CS) in 4 cases; MINO+IPM/CS+tobramycin in 1 case; MINO+cefmetazole (CMZ) in 1 cases; and MINO+fosfomycin+CMZ (changed to MINO+Amikacin) in 1 case, a total of 9 cases. Clinical result showed remarkable effectiveness of these therapies in 3 cases with some degrees of effectiveness in 6 cases, thus the therapies were all effective or better. 2. No particular abnormality was observed in subjective or objective symptoms or clinical laboratory tests, judged from values obtained before and after administration of MINO. The above results agreed with well those of the basic assessment, suggesting the possibility that the chemotherapies mainly using MINO would exhibit effectiveness on MRSA infections.

Topics: Adult; Aged; Cefmetazole; Cilastatin; Cilastatin, Imipenem Drug Combination; Drug Combinations; Drug Therapy, Combination; Humans; Imipenem; Male; Methicillin; Middle Aged; Minocycline; Penicillin Resistance; Postoperative Complications; Staphylococcal Infections; Staphylococcus aureus; Stomach Neoplasms; Tetracyclines

Minocycline pleurodesis with intrapleural pretreatment of lidocaine (150 mg) was performed on 19 patients. Minocycline was instilled into the pleural space for postoperative air leakage in 12 patients and control of malignant pleural effusion in 7 patients. Postoperative air leakage persisted longer than seven days was indicated instillation of minocycline (300 mg) with thoracostomy drainage. Satisfactory results were obtained in 11 of the 12 patients (92%) treated with this method. In 7 patients to control malignant pleural effusion, only one of these patients had recurrence of pleural effusion. Seventeen patients of all 19 subjects were free of pain following pleurodesis. None of these patients had a side effect of lidocaine. In conclusion of instillation, minocycline with thoracostomy drainage is a safe and an effective technique.

Topics: Adult; Aged; Aged, 80 and over; Breast Neoplasms; Drug Evaluation; Female; Humans; Instillation, Drug; Lung Neoplasms; Male; Middle Aged; Minocycline; Pleural Effusion; Pneumonectomy; Pneumothorax; Postoperative Complications; Tetracyclines; Thorax

Minocycline prophylaxis was compared with a placebo in 126 consecutive patients undergoing hysterectomy. The double-blind nature of this study was guarded until the study was completed. Of 95 patients who had abdominal hysterectomies, 32.7% on minocycline and 39.1% on placebo developed infectious complications. Of 31 vaginal hysterectomy patients, 20% on minocycline and 37.5% on the placebo developed septic complications (p less than 0.05). Although minocycline inhibited B. fragilis and E. coli effectively, those organisms colonized increasingly during the postoperative period with similar frequency in both the minocycline- and placebo-treated groups. Minocycline did not produce antibiotic-resistant strains. In our study the parenteral and oral forms of minocycline were found to be safe, and vestibular symptoms were no more common than in the placebo group. These data suggest that antibiotic prophylaxis with minocycline is safe and well tolerated. In addition, minocycline is effective in lowering the infection rate in vaginal, but not abdominal, hysterectomies.

Topics: Bacterial Infections; Double-Blind Method; Female; Humans; Hysterectomy; Hysterectomy, Vaginal; Microbial Sensitivity Tests; Minocycline; Postoperative Complications; Premedication; Random Allocation; Tetracyclines

Two cases of Noca dia asteroides infection were encountered out of 55 kidney transplant patients at Chiba University Hospital. One patient developed an extrapleural abscess and the other had a pulmonary infiltration with chest wall abscess. The patients were successfully treated by surgical drainage of the chest wall abscesses and by oral administration of minocycline. No adverse effects caused by minocycline were observed during the therapy. From 1900, when the first case of Nocardia infection was reported in Japan, there have been 60 cases reported in Japanese literature through 1973, including those we observed. This is the first report on nocardiosis in kidney transplant patients and on successful treatment of nocardiosis with minocycline in Japan.

Topics: Abscess; Adult; Glomerulonephritis; Humans; Kidney Transplantation; Male; Minocycline; Nocardia asteroides; Nocardia Infections; Pleural Effusion; Postoperative Complications; Tetracyclines; Transplantation, Homologous

Topics: Adult; Aged; Bacterial Infections; Female; Humans; Injections, Intravenous; Male; Middle Aged; Minocycline; Postoperative Complications; Tetracyclines

Topics: Adult; Aged; Cystitis; Drug Resistance, Microbial; Escherichia coli; Female; Humans; Infusions, Parenteral; Klebsiella; Male; Middle Aged; Minocycline; Postoperative Complications; Prostatic Hyperplasia; Prostatic Neoplasms; Proteus; Pseudomonas; Pyelonephritis; Staphylococcus; Tetracycline; Urologic Diseases

Topics: Aged; Bile; Carcinoma, Hepatocellular; Cholelithiasis; Humans; Infusions, Parenteral; Liver Neoplasms; Male; Middle Aged; Minocycline; Postoperative Complications; Tetracycline; Time Factors

Topics: Adult; Ampicillin; Aspergillus fumigatus; Drug Synergism; Erythromycin; Humans; Kidney Transplantation; Lung Diseases; Male; Minocycline; Nocardia asteroides; Nocardia Infections; Postoperative Complications; Sputum; Tetracycline; Transplantation, Homologous