<i>In Vivo</i>
            and
            <i>In Vitro</i>
            Efficacy of Minocycline-Based Combination Therapy for Minocycline-Resistant Acinetobacter baumannii

Yang, Ya-Sung; Lee, Yi; Tseng, Kuo-Chuan; Huang, Wei‐Cheng; Chuang, Ming-Fen; Kuo, Shu‐Chen; Lauderdale, Tsai‐Ling; Chen, Te‐Li

doi:10.1128/aac.02994-15

Cited by 40 publications

(31 citation statements)

References 32 publications

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“…They also determined the synergy of the combination using the fractional inhibitory concentration index (FICI). Yang et al (22) tested the colistin and minocycline combination against four minocycline-resistant and colistin-sensitive isolates (minocycline MICs of 16 and 32 mg/liter; colistin MIC, 0.5 mg/liter) and revealed similar FICI results using a checkerboard synergy assay (22). Time-kill experiments in the same study using minocycline at 4 and 16 mg/liter in combination with colistin at 0.5 mg/liter showed synergy in all four isolates.…”

Section: Discussionmentioning

confidence: 95%

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In Vitro Assessment of Combined Polymyxin B and Minocycline Therapy against Klebsiella pneumoniae Carbapenemase (KPC)-Producing K. pneumoniae

Huang

Diep

et al. 2017

Antimicrob Agents Chemother

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The multidrug resistance profiles of carbapenemase (KPC) producers have led to increased clinical polymyxin use. Combination therapy with polymyxins may improve treatment outcomes, but it is uncertain which combinations are most effective. Clinical successes with intravenous minocycline-based combination treatments have been reported for infections caused by carbapenemase-producing bacteria. The objective of this study was to evaluate the activity of polymyxin B and minocycline combination therapy against six KPC-2-producing isolates (minocycline MIC range, 2 to 32 mg/liter). Polymyxin B monotherapy (0.5, 1, 2, 4, and 16 mg/liter) resulted in a rapid reduction of up to 6 log in bactericidal activity followed by regrowth by 24 h. Minocycline monotherapy (1, 2, 4, 8, and 16 mg/liter) showed no reduction of activity of>1.34 log against all isolates, although concentrations of 8 and 16 mg/liter prolonged the time to regrowth. When the therapies were used in combination, rapid bactericidal activity was followed by slower regrowth, with synergy (60 of 120 combinations at 24 h, 19 of 120 combinations at 48 h) and additivity (43 of 120 combinations at 24 h, 44 of 120 combinations at 48 h) against all isolates. The extent of killing was greatest against the more susceptible polymyxin B isolates (MICs of ≤0.5 mg/liter) regardless of the minocycline MIC. The pharmacodynamic activity of combined polymyxin B-minocycline therapy against KPC-producing is dependent on polymyxin B susceptibility. Further and animal studies must be performed to fully evaluate the efficacy of this drug combination.

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Section: Discussionmentioning

confidence: 95%

“…Several hypotheses may explain the efficacy of this combination (20,22,23). Polymyxin B might increase membrane permeability and intracellular minocycline concentrations.…”

Section: Discussionmentioning

confidence: 99%

In Vitro Assessment of Combined Polymyxin B and Minocycline Therapy against Klebsiella pneumoniae Carbapenemase (KPC)-Producing K. pneumoniae

Huang

Diep

et al. 2017

Antimicrob Agents Chemother

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“…Minocycline is recommended as an alternative therapy against MDR AB (11,27), even for minocyclineresistant AB (28). Additionally, minocycline allows greater penetration of the BBB (29).…”

Section: Discussionmentioning

confidence: 99%

A combined strategy for postoperative patients with central nervous system infections caused by XDR/PDR Acinetobacter baumannii: a retrospective study

Chang

Chen

Wang

et al. 2019

Preprint

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Background Postoperative central nervous system infections (PCNSIs) caused by extensively drug-resistant (XDR) or pandrug-resistant (PDR) Acinetobacter baumannii are rare but intractable problems. To investigate a potential combined strategy to treat AB organisms that are resistant to not only meropenem but also colistin. Methods We retrospectively reviewed cerebrospinal fluid positive culture isolates of AB in patients who underwent neurosurgery. Medical records were collected by standard forms and analyzed. Results 16 patients met the criteria and most patients were middle-aged men who had undergone craniotomy or endonasal transsphenoidal surgery. 68.8% AB isolates were XDR bacteria, and 18.8% isolates were PDR bacteria. 12 patients were treated by meropenem-based regimen strategy. Another 4 patients were administered tetracycline-based regimens. 93.8% patients were treated with therapeutic drainage, and strict hygiene rules were followed. Finally, 12 patients survived their infections, and the average Glasgow Outcome Scale score was 2.9±1.4 at discharge. And the mortality rates of carbapenem-resistant AB (CRAB) were 8.3%. Conclusions PCNSIs caused by XDR/PDR AB are a rare and serious complication. Combined therapy based on the individual situation, including appropriate antimicrobial agents, surgical management and strict hygiene management, might be an effective therapeutic strategy.

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“…In vitro effects of N-acetylcysteine alone and combined with tigecycline on planktonic cells and biofilms of Acinetobacter baumannii Biofilm formation is one mechanism for the bacteria to acquire resistance to most of the antibiotics (3)(4)(5)(6); whereas, traditional antibiotics have restricted effects on preventing biofilm formation due to the failure to reach high serum concentration and tissue concentration (7)(8)(9). Previous research has demonstrated that A. baumannii had strong ability to form biofilms (10).…”

Section: Original Articlementioning

confidence: 99%

In vitro effects of N-acetylcysteine alone and combined with tigecycline on planktonic cells and biofilms of Acinetobacter baumannii

Feng¹,

Liu²,

Xu³

et al. 2018

J. Thorac. Dis.

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In Vivo and In Vitro Efficacy of Minocycline-Based Combination Therapy for Minocycline-Resistant Acinetobacter baumannii

Cited by 40 publications

References 32 publications

In Vitro Assessment of Combined Polymyxin B and Minocycline Therapy against Klebsiella pneumoniae Carbapenemase (KPC)-Producing K. pneumoniae

In Vitro Assessment of Combined Polymyxin B and Minocycline Therapy against Klebsiella pneumoniae Carbapenemase (KPC)-Producing K. pneumoniae

A combined strategy for postoperative patients with central nervous system infections caused by XDR/PDR Acinetobacter baumannii: a retrospective study

In vitro effects of N-acetylcysteine alone and combined with tigecycline on planktonic cells and biofilms of Acinetobacter baumannii

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