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Open AccessReview

Use of Oral Tetracyclines in the Treatment of Adult Patients with Community-Acquired Bacterial Pneumonia: A Literature Review on the Often-Overlooked Antibiotic Class

1
Massachusetts General Hospital, Boston, MA 02114, USA
2
College of Pharmacy, University of Michigan, Ann Arbor, MI 48109, USA
3
Albany College of Pharmacy and Health Sciences, Albany, NY 12208, USA
*
Author to whom correspondence should be addressed.
Antibiotics 2020, 9(12), 905; https://doi.org/10.3390/antibiotics9120905
Received: 15 November 2020 / Revised: 8 December 2020 / Accepted: 11 December 2020 / Published: 14 December 2020
(This article belongs to the Special Issue Antimicrobial Resistance: The Final Frontier)
Oral tetracyclines have been used in clinical practice for over 60 years. Overall, one of the most common indications for use of oral tetracyclines is for treatment of adult outpatients with lower respiratory tract infections, including community-acquired pneumonia (CAP). Despite the longstanding use of oral tetracyclines, practice patterns indicate that they are often considered after other guideline-concordant oral CAP treatment options (namely macrolides, fluoroquinolones, and β-lactams). However, there are growing resistance or safety concerns with the available oral agents listed for outpatients with CAP in the updated American Thoracic Society (ATS)/Infectious Diseases Society of America (IDSA) CAP guidelines, especially among patients with comorbidities or notable risk factors for resistant pathogens. Given the need for alternative oral agents to macrolides, fluoroquinolones, and beta-lactams for adult outpatients with CAP, this review summarizes the literature on the use of oral tetracyclines (i.e., doxycycline, minocycline, and omadacycline) for this indication. As part of this review, we described their mechanism of action, common mechanisms of resistance, susceptibility profiles against common CAP pathogens, pharmacokinetics, pharmacodynamics, clinical data, and safety. The intent of the review is to highlight the important considerations when deciding between doxycycline, minocycline, and omadacycline for an adult outpatient with CAP in situations in which use of an oral tetracycline is warranted. View Full-Text
Keywords: tetracycline; pneumonia; community-acquired pneumonia; doxycycline; minocycline; omadacycline tetracycline; pneumonia; community-acquired pneumonia; doxycycline; minocycline; omadacycline
MDPI and ACS Style

Bidell, M.R.; Pai, M.P.; Lodise, T.P. Use of Oral Tetracyclines in the Treatment of Adult Patients with Community-Acquired Bacterial Pneumonia: A Literature Review on the Often-Overlooked Antibiotic Class. Antibiotics 2020, 9, 905. https://doi.org/10.3390/antibiotics9120905

AMA Style

Bidell MR, Pai MP, Lodise TP. Use of Oral Tetracyclines in the Treatment of Adult Patients with Community-Acquired Bacterial Pneumonia: A Literature Review on the Often-Overlooked Antibiotic Class. Antibiotics. 2020; 9(12):905. https://doi.org/10.3390/antibiotics9120905

Chicago/Turabian Style

Bidell, Monique R.; Pai, Manjunath P.; Lodise, Thomas P. 2020. "Use of Oral Tetracyclines in the Treatment of Adult Patients with Community-Acquired Bacterial Pneumonia: A Literature Review on the Often-Overlooked Antibiotic Class" Antibiotics 9, no. 12: 905. https://doi.org/10.3390/antibiotics9120905

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Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

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