The Role of Minocycline in the Treatment of Nosocomial Infections Caused by Multidrug, Extensively Drug and Pandrug Resistant Acinetobacter baumannii: A Systematic Review of Clinical Evidence

Treatment options for multidrug resistant strains (MDR-AB) are limited. Minocycline has been used alone or in combination in the treatment of infections associated with AB. A systematic review of the clinical use of minocycline in nosocomial infections associated with MDR-AB was performed according...

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Published in:Microorganisms (Basel) 2019-06, Vol.7 (6), p.159
Main Authors: Fragkou, Paraskevi C, Poulakou, Garyfallia, Blizou, Andromachi, Blizou, Myrto, Rapti, Vasiliki, Karageorgopoulos, Drosos E, Koulenti, Despoina, Papadopoulos, Antonios, Matthaiou, Dimitrios K, Tsiodras, Sotirios
Format: Article
Language:English
Subjects:
Acinetobacter baumannii
Antibiotics
Antiinfectives and antibacterials
Antimicrobial agents
antimicrobial drug resistance
Carbapenems
Colistin
Drug dosages
MDR
Minocycline
Mortality
Multidrug resistance
Nosocomial infection
Nosocomial infections
Pathogens
Patients
PDR
Pneumonia
Review
Search engines
Systematic review
Ventilator-associated pneumonia
XDR
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Summary:Treatment options for multidrug resistant strains (MDR-AB) are limited. Minocycline has been used alone or in combination in the treatment of infections associated with AB. A systematic review of the clinical use of minocycline in nosocomial infections associated with MDR-AB was performed according to the PRISMA-P guidelines. PubMed-Medline, Scopus and Web of Science databases were searched from their inception until March 2019. Additional Google Scholar free searches were performed. Out of 2990 articles, 10 clinical studies (9 retrospective case series and 1 prospective single center trial) met the eligibility criteria. In total, 223 out of 268 (83.2%) evaluated patients received a minocycline-based regimen; and 200 out of 218 (91.7%) patients with available data received minocycline as part of a combination antimicrobial regimen (most frequently colistin or carbapenems). Pneumonia was the most common infection type in the 268 cases (80.6% with 50.4% ventilator-associated pneumonia). The clinical and microbiological success rates following minocycline treatment were 72.6% and 60.2%, respectively. Mortality was 20.9% among 167 patients with relevant data. In this systematic review, minocycline demonstrated promising activity against MDR-AB isolates. This review sets the ground for further studies exploring the role of minocycline in the treatment of MDR-AB associated infections.
ISSN:2076-2607
2076-2607
DOI:10.3390/microorganisms7060159