Introduction
- Minocycline inhibits the growth of Propionibacterium acnes. Anti-inflammatory actions.
- Drug Class: Antibiotic, Anti-inflammatory-long acting tetracycline.
Clinical Experience
- Oral antibiotics have had a significant role in the treatment of inflammatory disease such as acne, rosacea, perioral dermatitis and others. Tetracycline has long been the first line antibiotic for acneform eruptions because of its efficacy and affordability although in inconvenience of divides doses on an empty stomach has compromised compliance in some. P. acnes resistance to Tetracycline and Erythromycin has meant looking elsewhere for an alternative antibiotic. Bacterial resistance to Minocycline has been much slower to develop.
- Topical therapy should always be used in combination with oral antibiotics and the combination of benzoyl peroxide may reduce the ability of bacteria to become resistant.
- Minocycline has shown itself to be effective, convenient and well tolerated for most. The incidence of serious side effects is rare. There is a trend away from using these drugs for a long time such as a minimum of six months and toward short courses that aim at stopping new inflammatory lesions and then maintain control with topical therapy which could be combined with oral contraceptives.
- Minocycline and doxycycline are more expensive than tetracycline and erythromycin and for some this is an important consideration.
- Proper selection and appropriate monitoring of patients has made this drug a first line antibiotic for many dermatologists.
Patient Profile
ADULT
Suitable patients
- Any inflammatory acne or rosacea patient who is not likely to respond to topical therapy alone. If scarring present or nodulocystic acne a more aggressive approach may be necessary.
- Those who prefer the convenience of single dose a day as well as being able to take the drug with food.
- Those who understand that the risk of significant side effects is very uncommon.
Unsuitable patients
- Avoid in SLE patients and their 1st degree relatives.
- Avoid in significant hepatic and renal disease
- Check LFT and ANA if suspicious symptoms of hypersensitivity.
- Avoid all tetracyclines if history of hypersensitivity to Minocycline.
PEDIATRIC
Unsuitable patients
Not recommended in children under 8 years of age as permanent enamel hyperplasia, discoloration of teeth, and inhibition of fetal skeletal growth may occur.
