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Efficacy and Safety of Tetracyclines in Bone and Joint Infections: A Literature Review - PubMed

5 hours ago
  • #Bone and Joint Infections
  • #Multidrug-Resistant Pathogens
  • #Tetracyclines
  • Tetracyclines offer favorable bone penetration and oral bioavailability with activity against multidrug-resistant pathogens.
  • Experimental studies show strong bone affinity but inconsistent tissue concentrations and insufficient monotherapy against biofilms.
  • Clinical trials found tetracyclines inferior to standard regimens, though observational studies show variable efficacy (40-80%) in salvage therapy for MDR infections.
  • Tolerability issues include frequent gastrointestinal intolerance.
  • Guidelines recommend tetracyclines for zoonotic infections (e.g., Brucella) and as suppressive therapy in select prosthetic joint infections, but evidence is weak compared to fluoroquinolones.
  • Data are heterogeneous, largely observational; robust prospective studies are needed, especially for newer agents like omadacycline and eravacycline.