Minocycline, focus on mechanisms of resistance, antibacterial activity, and clinical effectiveness: Back to the future

• Published in: Journal of global antimicrobial resistance. Vol. 22; pp. 161 - 174
• Main Authors: Asadi, Arezoo, Abdi, Milad, Kouhsari, Ebrahim, Panahi, Pegah, Sholeh, Mohammad, Sadeghifard, Nourkhoda, Amiriani, Taghi, Ahmadi, Alireza, Maleki, Abbas, Gholami, Mehrdad
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.09.2020; Elsevier
• Subjects: Mechanisms of minocycline resistance; Minocycline antibacterial activity; Minocycline clinical effectiveness; Minocycline resistance; Minocycline clinical effectiveness; Minocycline resistance; Minocycline antibacterial activity; Mechanisms of minocycline resistance
• ISSN: 2213-7165; 2213-7173
• DOI: 10.1016/j.jgar.2020.01.022

•Minocycline have a broad-spectrum and active against MDR bacteria.•Due to the side effects, its use in bacterial infections have been limited.•The efflux pumps and modification of the drug target sites caused resistance to it.•The tet efflux genes decreasing the MIC of the drug intracellularly. The increasing crisis regarding multidrug-resistant (MDR) and extensively drug-resistant microorganisms leads to appealing therapeutic options. During the last 30 years, minocycline, a wide-spectrum antimicrobial agent, has been effective against MDR Gram-positive and Gram-negative bacterial infections. As with other tetracyclines, the mechanism of action of minocycline involves attaching to the bacterial 30S ribosomal subunit and preventing protein synthesis. This antimicrobial agent has been approved for the treatment of acne vulgaris, some sexually transmitted diseases and rheumatoid arthritis. Although many reports have been published, there remains limited information regarding the prevalence, mechanism of resistance and clinical effectiveness of minocycline. Thus, we summarize here the currently available data concerning pharmacokinetics and pharmacodynamics, mechanism of action and resistance, antibacterial activity and clinical effectiveness of minocycline.