1982 Volume 30 Issue 11 Pages 1257-1269
Patients with severe pulmonary and urinary tract infections who had responded poorly to a prior chemotherapy were treated with minocycline in combination with aminoglycoside. The efficacy of the combined therapy in treatment of these patients was evaluated.
Sixteen patients with pulmonary infection and one patient with urinary tract infection were included in this study. In all of these patients the prior chemotherapy was interrupted, because of the lack of response or side effects. To these 17 patients 100mg of minocycline and a conventional dose of aminoglycoside (dibekacin, amikacin or gentamicin) were given by intravenous drip infusion and intramusculary twice a day, respectively.
Clinical response to the above combination therapy was excellent in 5 patients, good in 9 patients and fairly good in 2 patients. In the remaining one patient response was poor. Thirteen strains of pathogenic microorganisms were cultured from the specimen of these patients; 3 strains each of S. pneumoniae and E. coil, 2 strains of Acinetobacter and 1 strain each of H. influenzae, S. marcescens, K. pneumoniae, P. aeruginosa and Alcaligenes. Eleven of the 13 pathogens were eradicated from the specimen and 2 pathogens markedly decreased in number.
Then in vitro combined effects of minocycline plus gentamicin on a strain of Serratia marcescens from the sputum of a patient included in this study was examined. When these two drugs were combined, a remarkable synergistic potentiation of antimicrobial activity was found, as evidenced by a fractional inhibitory concentration index of 0.094.
The elevation of low grade of serum transaminases was found in three patients and that of alkaline phosphatase in one patient. But the results of liver function tests turned to be normal upon cessation of the combined therapy.
It is concluded that the combination of minocycline and aminoglycoside is of value in the treatment of patients who had severe infections of the lung or urinary tract and had poorly responded to or had not tolerated the prior treatment with β-lactam alone or with β-lactam plus aminoglycoside.
