Background: Antimicrobial Stewardship Programs should consider old antimicrobials for emerging multidrug-resistant (MDR) organisms such as Acinetobacter baumannii. Our purpose is to evaluate susceptibilities of minocycline to MDR-A. baumannii and assess the outcomes of patients treated with minocycline.
Methods: Consecutive isolates from 67 patients with MDR-A. baumannii were tested to determine susceptibilities to tetracycline, minocycline, tigecycline, ampicillin/sulbactam, imipenem/cilastatin, and colistin. Patients receiving minocycline from September 1, 2010, to March 31, 2011 were analyzed for demographics, penicillin allergy, clinical and microbiologic response, length of stay (LOS), infection-related LOS, and mortality.
Results: Minocycline was susceptible to 32 (48%) of 67 A. baumannii isolates. Of the imipenem/cilastatin- and ampicillin/sulbactam-resistant isolates, minocycline was susceptible to 18 (38%) of 47. Five patients received minocycline in combination with ampicillin/sulbactam or colistin for pneumonia (n = 3), bacteremia (n = 1), and skin and soft tissue infection (n = 1). The median treatment duration, LOS, and the infection-related LOS were 10, 34, and 21 days, respectively. All patients had microbiologic cure, and 4 had clinical response.
Conclusions: Minocycline showed clinical utility for MDR-A. baumannii infections. Antimicrobial Stewardship Programs should consider minocycline for MDR-A. baumannii infections and monitor patient outcomes.
From the Departments of *Pharmacy and †Pathology, The Ohio State University Medical Center, Columbus, OH.
Correspondence to: Debra A. Goff, PharmD, FCCP, Department of Pharmacy, The Ohio State University Medical Center, 368 Doan Hall, 410 W. 10th Ave, Columbus, OH 43210. E-mail: Debbie.email@example.com.
The authors have no funding or conflicts of interest to disclose.
Dr Jankowski is currently at Shands Jacksonville Department of Pharmacy, Jacksonville, FL.