When most of us think about minocycline it is for the oral treatment of gram positive infection, in particular MRSA. In fact, the drug is effective against multidrug resistant gram negative organisms, including Acinetobacter baumannii (AB). This point was driven home to me recently when I saw that my favorite ID journal Clinical Infectious Diseases just published a supplement on the topic. Here is the link to the Table of Contents. All of the articles are available as free full text and can be downloaded from this link:
This supplement was sponsored by The Medicines Company www.themedicinescompany.com who are now marketing an IV formulation of minocycline for this purpose so take that into account while reading the papers. That being said, both of the Guest Editors, Debra Goff, PharmD and Keith Kaye MD, MPH are top quality, fair balanced researchers and authors. (Disclosure: I have NO financial relationship with this company)
The efficacy of minocycline against AB should not come as a huge surprise. Tigecycline, a minocycline derivative, is often considered one of the drugs of choice for both ESBL and CRE producing gram negatives including MDR-AB.
Also of interest in this Supplement is a brief obituary for one of the true giants in the field of Infectious Diseases, Robert Moellering, Jr, MD. I had the opportunity to meet Bob on a few occasions at various meetings and advisory boards. He was a true gentleman who worked closely with the podiatrists at The Beth Israel Deaconess in Boston. Over the years I have read his work and marveled at his brilliance. He will be missed.