minocycline

What is minocycline, and what is it used for?

Minocycline belongs to the tetracycline class of antibiotics, used to treat a wide variety of bacterial infections. Tetracyclines are bacteriostatic antibiotics that prevent the growth of bacteria, but do not directly kill them (bactericidal).

Minocycline is effective against many species of gram-positive and gram-negative bacteria. These two types of bacteria are structurally different and are identified by the Gram stain lab test.

Minocycline works by inhibiting the synthesis of proteins that bacteria require to survive and grow. Minocycline binds to 30S and 50S subunits in the bacterial ribosomes (cellular particles that synthesize proteins) and prevents the formation of protein chains from amino acids. Although minocycline is active against many species of gram-positive and gram-negative bacteria, many strains have developed resistance to the drug, and it is recommended to be used only after culture and susceptibility tests.

FDA-approved uses of minocycline include treatment of the following infections from susceptible strains of organisms:

• Rocky Mountain spotted fever, typhus fever, and the typhus group, Q fever, rickettsialpox, and tick fevers caused by Rickettsiae
• Respiratory tract infections caused by Mycoplasma pneumoniae, Haemophilus influenzae, and Klebsiella species
• Upper respiratory tract infections caused by Streptococcus pneumoniae
• Lymphogranuloma venereum caused by Chlamydia trachomatis
• Psittacosis (ornithosis) due to Chlamydia psittaci
• Trachoma caused by Chlamydia trachomatis
• Inclusion conjunctivitis caused by Chlamydia trachomatis
• Nongonococcal urethritis, endocervical, or rectal infections in adults caused by Ureaplasma urealyticum, or Chlamydia trachomatis
• Relapsing fever due to Borrelia recurrentis
• Chancroid caused by Haemophilus ducreyi
• Plague due to Yersinia pestis
• Tularemia due to Francisella tularensis
• Cholera caused by Vibrio cholerae
• Campylobacter fetus infections
• Brucellosis due to Brucella species (in conjunction with streptomycin)
• Bartonellosis due to Bartonella bacilliformis
• Granuloma inguinale caused by Calymmatobacterium granulomatis
• Skin and skin structure infections caused by Staphylococcus aureus (minocycline is not the drug of choice in the treatment of any type of staphylococcal infection)
• To eliminate the meningococci from the nasopharynx of asymptomatic carriers of Neisseria meningitidis

As an alternative drug when penicillin is contraindicated:

• Uncomplicated urethritis in men due to Neisseria gonorrhoeae and for the treatment of other gonococcal infections
• Infections in women caused by Neisseria gonorrhoeae
• Syphilis caused by Treponema pallidum subspecies pallidum
• Yaws caused by Treponema pallidum subspecies pertenue
• Listeriosis due to Listeria monocytogenes
• Anthrax due to Bacillus anthracis
• Vincent’s infection caused by Fusobacterium fusiforme
• Actinomycosis caused by Actinomyces israelii
• Infections caused by Clostridium species.

Adjunctive therapy

Off-label uses include:

Susceptible organisms include the following:

Acinetobacter baumannii, Actinomyces species, Afipia felis, Bacteroides species, Bartonella bacilliformis, Borrelia recurrentis, Brucella species, Burkholderia cepacia, Klebsiella granulomatis, Campylobacter jejuni, Chlamydia species, Clostridium species, Coxiella burnetii, Eikenella corrodens, Escherichia coli, Entamoeba species, Francisella tularensis, Haemophilus ducreyi, Legionella pneumophila, Leptospira interrogans, Listeria monocytogenes, Mycoplasma hominis, Mycoplasma pneumoniae, Neisseria meningitidis, Neisseria gonorrhoeae, Nocardia asteroides, Prevotella melaninogenica, Propionibacterium acnes, Rickettsiae, Shigella species, MRSA, Streptococcus pneumoniae, Streptococcus pyogenes, Treponema pallidum, Ureaplasma urealyticum, Vibrio cholerae, Yersinia pestis, Yersinia enterocolitica, Yersinia pseudotuberculosis, and mycobacteria other than tuberculosis