미노사이클린

테트라사이클린계 항생제Highly Important

미노사이클린은 지용성이 높은 2세대 **테트라사이클린계 항생제**입니다. 혈액뇌장벽(BBB)을 통과하고 전립선에 침투하는 등 조직 침투력이 매우 뛰어난 것이 특징입니다. - **임상 용도:** 브루셀라증, 라임병, 혈액 마이코플라스마증, 비정형 마이코박테리아 감염 및 내성 원내 감염. - **장점:** 기존의 수용성 테트라사이클린에 비해 뼈와 치아 이상을 유발할 가능성이 적습니다. 중등도의 신기능 저하 환자에게도 용량 조절 없이 안전하게 사용할 수 있습니다. - **추가 특성:** 항균 효과 외에도 **항염증** 및 **신경 보호** 특성(예: 기질 금속단백분해효소 억제)을 보여 혈관육종과 같은 질환의 보조 요법으로 연구되었으나, 초기 결과는 실망스러웠습니다.

작용 기전: Minocycline is a **bacteriostatic** antibiotic that exhibits time-dependent (AUC/MIC) inhibition of bacterial growth. - **Primary Mechanism:** Reversibly binds to the **30S ribosomal subunit** of susceptible organisms → blocks the binding of aminoacyl transfer-RNA to the mRNA-ribosome complex → **inhibits bacterial protein synthesis**. - **Secondary Mechanism:** Reversibly binds to the **50S ribosomal subunit** → alters cytoplasmic membrane permeability, leading to leakage of intracellular components. - **Mammalian Effects:** At very high concentrations, it can inhibit mammalian protein synthesis. It also inhibits **matrix metalloproteinases (MMPs)** and apoptosis, contributing to its anti-inflammatory and neuroprotective effects.

동물 종별 용량

Cats

Hemotropic mycoplasmosis · 6-11 mg/kg PO q12h · PO · q12h · 21 days
Adjunctive treatment atypical mycobacterial dermal infections · 5-12.5 mg/kg PO, IV q12h · PO, IV · q12h
Adjunctive treatment of Nocardiosis, Actinomycosis · 5-25 mg/kg PO, IV q12h · PO, IV · q12h
Susceptible mycobacterial, L-Forms, or mycoplasma infections · 5-12.5 mg/kg PO q12h · PO · q12h
Bacterial, rickettsial, mycoplasmal and chlamydial diseases · 5-10 mg/kg · PO · q12h · Avoid dry pilling; follow with a water bolus.

Dogs

Susceptible soft tissue and urinary tract infections · 5-12 mg/kg PO or IV q12h · PO, IV · q12h · 7-14 days
Brucellosis · 25 mg/kg PO once daily (q24h) · PO · q24h · 4 weeks · Given with Gentamicin 5 mg/kg SC once daily for 7 days (weeks 1 and 4). Doxycycline can eventually be substituted. May need two or more 4-week courses.
Adjunctive treatment of Nocardiosis, Actinomycosis · 5-25 mg/kg PO, IV q12h · PO, IV · q12h
Brucellosis in animals that are housed singly and neutered · 25 mg/kg PO once daily · PO · q24h · 14 days · Given with dihydrostreptomycin at 5 mg/kg IM twice daily for 7 days.
Ehrlichiosis (E. canis) · 10 mg/kg PO (rarely IV) q12h · PO, IV · q12h · 28 days · For dogs with a positive test result and clinical signs consistent with the infection.

투여 경로

POIV

금기

Hypersensitivity to tetracyclines
Pregnant or nursing animals
Animals less than 6 months old (relative contraindication)
Pregnancy
Young, developing animals

이상반응

Nausea and vomiting (most common)
Dental or bone staining (if exposed in utero or early life)
Increases in hepatic enzymes (rare)
Ototoxicity (rare)
Urticaria, shivering, hypotension, dyspnea, cardiac arrhythmias, and shock (if given rapidly IV)
Superinfections (overgrowth of non-susceptible bacteria or fungi)
Photosensitivity (reported in humans)
Hepatotoxicity or blood dyscrasias (rare, reported in humans)
CNS effects like dizziness/lightheadedness (reported in humans)
Blue-gray pigmentation of skin and mucous membranes (reported in humans)
Nausea
Vomiting
Diarrhoea
Bone and teeth abnormalities (in developing animals)
Oesophageal erosions (especially in cats if dry-pilled)

약물 상호작용

Antacids, Oral (Aluminum, Calcium, Magnesium, Zinc, Bismuth) · Can chelate divalent or trivalent cations, decreasing absorption of the tetracycline. Give at least 12 hours before or after the cation-containing product.
Bismuth subsalicylate, Kaolin, Pectin · May reduce minocycline absorption.
Iron, Oral · Decreased tetracycline absorption. Give iron salts 3 hours before or 2 hours after the tetracycline dose.
Isotretinoin · May increase the risk for nervous system effects when used concurrently.
Penicillins, Cephalosporins, Aminoglycosides · Bacteriostatic drugs may interfere with the bactericidal activity of these antibiotics (clinical significance is controversial).
Warfarin · Tetracyclines may depress plasma prothrombin activity; anticoagulant dosage adjustment may be needed.
Antacids · Reduced absorption of minocycline · moderate
Calcium salts · Reduced absorption of minocycline · moderate
Magnesium salts · Reduced absorption of minocycline · moderate
Iron salts · Reduced absorption of minocycline · moderate
Sucralfate · Reduced absorption of minocycline · moderate
Phenobarbital · Increased metabolism of minocycline, decreasing plasma levels · moderate

모니터링

Clinical efficacy (resolution of infection)
Adverse effects (GI upset, signs of hypersensitivity)
Renal function (if used concurrently with nephrotoxic drugs like gentamicin)
Clinical efficacy
Gastrointestinal signs
Hepatic function (in patients with pre-existing liver disease)

과용량

Oral overdoses are most likely associated with **GI disturbances** (vomiting, anorexia, and/or diarrhea). - **Treatment:** Although less vulnerable to chelation than other tetracyclines, oral administration of divalent or trivalent cation antacids may bind some of the drug and reduce GI distress. - **Supportive Care:** Should the patient develop severe emesis or diarrhea, monitor fluids and electrolytes and replace if necessary.

VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.