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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

1
4th Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens; 12462 Athens, Greece
2
3rd Department of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
3
Adult Critical Care Unit, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
4
BTCCRC, UQCCR, Faculty of Medicine, University of Queensland, Brisbane, QLD 4072, Australia
*
Authors to whom correspondence should be addressed.
Microorganisms 2019, 7(6), 159; https://doi.org/10.3390/microorganisms7060159
Received: 11 April 2019 / Revised: 16 May 2019 / Accepted: 30 May 2019 / Published: 1 June 2019
(This article belongs to the Special Issue Multidrug-Resistant Pathogens)
Treatment options for multidrug resistant Acinetobacter baumannii 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 TM 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. View Full-Text
Keywords: minocycline; nosocomial infections; Acinetobacter baumannii; antimicrobial drug resistance; MDR; XDR; PDR minocycline; nosocomial infections; Acinetobacter baumannii; antimicrobial drug resistance; MDR; XDR; PDR
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Fragkou, P.C.; Poulakou, G.; Blizou, A.; Blizou, M.; Rapti, V.; Karageorgopoulos, D.E.; Koulenti, D.; Papadopoulos, A.; Matthaiou, D.K.; Tsiodras, S. 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. Microorganisms 2019, 7, 159.

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