Methods: A systematic review of the published literature examining the clinical use of minocycline in nosocomial infections associated with MDR-AB isolates (defined according to ECDC guidance) was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. PubMed, Scopus and Web of SciencesTM databases were searched from their inception until the 20thMarch 2018. Three researchers individually evaluated the available clinical studies according to predefined inclusion and exclusion criteria. No language restrictions were applied.
Results: Out of 2,576 articles, 9 clinical studies (8 retrospective case series and 1 prospective single center trial) met the eligibility criteria. In total, 221 out of 265 (83.4%) evaluated adult patients received a minocycline-based antimicrobial regimen and 44 out of 265 (16.6%) received other antimicrobial agents (most frequently aminoglycocides); 198 out of 216 (91.7%) patients with available data, received minocycline as part of an antimicrobial combination regimen (most frequently colistin and carbapenems). Pneumonia was the most prevalent infection (81.5% with 50.4% ventilator associated pneumonias). Clinical and microbiological success rates in the minocycline group were 72.4% and 59.7% respectively. Mortality rate was 21.2% among 165 patients with relevant data. In the non-minocycline group, clinical and microbiological cure rates were 45.5% and 18.2%, respectively.
Conclusion: In this systematic review, minocycline demonstrated promising activity against MDR-AB isolates. This study could set the grounds for further research with large randomized controlled trials that would explore and establish the role of minocycline in the treatment of MDR-AB associated infections.
P. C. Fragkou,
M. Blizou, None
A. Blizou, None
D. K. Matthaiou, None
S. Tsiodras, None