Minocycline

Minocycline is a drug from the class of tetracyclines. The antibiotic is used to treat respiratory infections, urinary tract infections or to treat borreliosis.

What is minocycline?

Minocycline is a tetracycline. Tetracyclines are drugs that have an antibiotic effect and are produced by bacteria of the Streptomyces species. In contrast to chlortetracycline, minocycline is not a natural product, but a semi-synthetic derivative. It is synthesized from oxytetracycline in a multi-step process. Bacteria of the species Streptomyces rimosus are suitable for obtaining the oxytetracycline.

Because of its broad spectrum of activity, minocycline is used to treat many diseases. Indications for the antibiotic are skin infections, eye infections, pneumonia, otitis media, syphilis, borreliosis or chronic bronchitis.

Pharmacological effect

Minocycline is an antibiotic. Antibiotics are drugs that kill bacteria or stop bacteria from growing. Tetracyclines, like the minocycline, fight both gram-positive bacteria and gram-negative bacteria. Gram-positive bacteria such as streptococci or staphylococci, in contrast to gram-negative bacteria such as Neisseria, Campylobacter or Brucella, do not have an additional outer cell wall.

Minocycline plays a special role in the treatment of infections caused by bacteria without a cell wall, such as rickettsiae, chlamydia or mycoplasma. Due to the lack of a cell wall, standard antibiotics such as cephalosporins or penicillins cannot do anything against these bacteria. However, there are more and more germs that are resistant to the antibiotic, especially in hospitals. In particular, some Proteus bacteria or bacteria of the Enterobacter species no longer respond to minocycline. Most of the pathogens from the Pseudomonas aeruginosa group are also considered resistant.

Minocycline inhibits protein synthesis on the ribosomes of bacteria. The accumulation of the aminoacyl-tRNA is prevented so that the bacteria cannot multiply.

Current research shows that minocycline is not exclusively antibiotic. Tests have shown neuroprotective and anti-inflammatory effects in the area of ​​the nervous system.

Medical application & use

Despite the increase in resistance to minocycline, the antibiotic is still the drug of choice in the treatment of Lyme disease and urethritis. Borreliosis is a disease that is transmitted by a tick bite. The pathogens are Borrelia (spirochetes). After multiplication at the point of entry, it spreads via the bloodstream. Various organ systems are affected. After a while, the clinical picture of the so-called Lyme borreliosis results. Lyme borreliosis is characterized by muscle and joint pain, lymph node swelling, paralysis, nerve pain and chronic fatigue.

Urethritis is the inflammation of the urethra. The condition is associated with itching, painful urination, and discharge. Minocycline is only effective against bacterial urethral infections that are not caused by Neisseria gonorrhoeae, the causative agent of gonorrhea.

The antibiotic is also used for sexually transmitted diseases such as syphilis and for kidney and urinary tract infections. Chlamydia infections are also treated with minocycline.

Minocycline is also used to treat respiratory infections. These include tonsillitis, sinus infections, and pneumonia. Minocycline is also given for inflammation of the middle ear (otitis media).

Rarely occurring indications for minocycline are bacterial infectious diseases such as ornithosis, bartonellosis, plague, rickettsiosis or brucellosis. Listeriosis, an infectious disease that causes flu-like symptoms, is also treated with minocycline.

The drug can also be used to treat severe acne. Minocycline can also be used as a preventive treatment against meningitis after contact with meningococcal infected people.

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Risks & side effects

Minocycline can lead to enamel hypoplasia. This can lead to irreversible yellowish to brownish discoloration of the teeth. Therefore, the antibiotic must not be used during pregnancy and before the age of eight.

Further contraindications are kidney dysfunction and liver dysfunction. Minocycline can cause photosensitization. It is an excessive sensitivity of the skin to light. Edema or erythema can therefore develop on the exposed parts of the body while taking minocycline. Frequent side effects are also heartburn, inflammation of the esophagus, gas, diarrhea, fatty stools and vomiting.

Occasionally fatigue, dizziness, muscle weakness, liver disorders or the development of a black hairy tongue occur. Occasionally, Stevens-Johnson syndrome develops with a widespread skin rash and fever. The formation of blood cells in the bone marrow is rarely disturbed. In addition, the blood pressure can drop sharply, the larynx swell or the intracranial pressure rise.

Severe diarrhea during or after therapy can be triggered by pseudomembranous colitis. In the case of such antibiotic-induced intestinal inflammation, therapy with minocycline must be stopped immediately and replaced with treatment with vancomycin.

If other antibiotics are administered at the same time, the effect may weaken each other. Acid-binding drugs, iron supplements, calcium supplements and activated charcoal inhibit the absorption of minocycline from the intestine. Barbiturates and anti-epileptics can also weaken the effect of the antibiotic.

Hormonal contraceptives like the "pill" can lose their effectiveness while taking minocycline. In addition, the effect of antidiabetic agents or anticoagulants can be impaired by the drug.

If the acne drug isotretinoin is administered at the same time, the risk of an increase in intracranial pressure increases. It should also be noted that the side effects of various anesthetics, theophylline, cyclosporine and methotrexate can be increased by minocycline.