Use of Oral Tetracyclines in the Treatment of Adult Patients with Community-Acquired Bacterial Pneumonia: A Literature Review on the Often-Overlooked Antibiotic Class
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 us...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-12-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/9/12/905 |
| _version_ | 1827700137374253056 |
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| author | Monique R. Bidell Manjunath (Amit) P. Pai Thomas P. Lodise |
| author_facet | Monique R. Bidell Manjunath (Amit) P. Pai Thomas P. Lodise |
| author_sort | Monique R. Bidell |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-10T14:06:09Z |
| format | Article |
| id | doaj.art-b102dd8c2cf34650bee7740f1ed7dc75 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T14:06:09Z |
| publishDate | 2020-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-b102dd8c2cf34650bee7740f1ed7dc752023-11-21T00:42:37ZengMDPI AGAntibiotics2079-63822020-12-0191290510.3390/antibiotics9120905Use of Oral Tetracyclines in the Treatment of Adult Patients with Community-Acquired Bacterial Pneumonia: A Literature Review on the Often-Overlooked Antibiotic ClassMonique R. Bidell0Manjunath (Amit) P. Pai1Thomas P. Lodise2Massachusetts General Hospital, Boston, MA 02114, USACollege of Pharmacy, University of Michigan, Ann Arbor, MI 48109, USAAlbany College of Pharmacy and Health Sciences, Albany, NY 12208, USAOral 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.https://www.mdpi.com/2079-6382/9/12/905tetracyclinepneumoniacommunity-acquired pneumoniadoxycyclineminocyclineomadacycline |
| spellingShingle | Monique R. Bidell Manjunath (Amit) P. Pai Thomas P. Lodise 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 tetracycline pneumonia community-acquired pneumonia doxycycline minocycline omadacycline |
| title | Use of Oral Tetracyclines in the Treatment of Adult Patients with Community-Acquired Bacterial Pneumonia: A Literature Review on the Often-Overlooked Antibiotic Class |
| title_full | Use of Oral Tetracyclines in the Treatment of Adult Patients with Community-Acquired Bacterial Pneumonia: A Literature Review on the Often-Overlooked Antibiotic Class |
| title_fullStr | Use of Oral Tetracyclines in the Treatment of Adult Patients with Community-Acquired Bacterial Pneumonia: A Literature Review on the Often-Overlooked Antibiotic Class |
| title_full_unstemmed | Use of Oral Tetracyclines in the Treatment of Adult Patients with Community-Acquired Bacterial Pneumonia: A Literature Review on the Often-Overlooked Antibiotic Class |
| title_short | Use of Oral Tetracyclines in the Treatment of Adult Patients with Community-Acquired Bacterial Pneumonia: A Literature Review on the Often-Overlooked Antibiotic Class |
| title_sort | use of oral tetracyclines in the treatment of adult patients with community acquired bacterial pneumonia a literature review on the often overlooked antibiotic class |
| topic | tetracycline pneumonia community-acquired pneumonia doxycycline minocycline omadacycline |
| url | https://www.mdpi.com/2079-6382/9/12/905 |
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