Tuesday January 10, 2006
Doxy or Mino ! - trick in the pocket for MRSA
Second generation tetracyclines has been used for MRSA (methicillin-resistant Staphylococcus aureus) for long time but with very few real data available. One study from 1984 showed cure rate of 76%.
Recently Ruhe and coll. look into the issue. Though its a small study of only 24 patients but showed cure rate of 83% with "serious" MRSA icluding skin/skin structure, septic arthritis, Bacteremia/sepsis, osteomyelitis, UTI. 13 patients were treated with Doxycycline and 11 were treated with Minocycline (5 patients in minocycline group were treated in combination with rifampin +/- bactrim). Patients were treated with 100 mg PO bid dose with median total treatment time of 19 days. Also, interestingly, no patient in minocycline group complaint of vertigo.
If intravenous access is an issue in a patient with serious MRSA, except for ZYVOX (linezolid) all mainstream drugs are available only in parenteral form. If Zyvox is contraindicated or not available - you have trick available in your pocket. Plus added advantage of cost-effectiveness.
References: Click to get abstract or article
1. Clumeck and coll. - Treatment of severe staph. infections with rifampin-minocyclin association - J of antimicrob chemother 1984;13 suppl. :C17-C22
2. Use of Long-Acting Tetracyclines for Methicillin-Resistant Staphylococcus aureus Infections: Case Series and Review of the Literature - Clin Infect Dis 40:1429-1434 electronically published 6 April 2005. - Caution: we found this link not working all the time but atleast refence is checked and available in hard print.