Aminoglycosides garamycin gentamicin and tobrex tobramycin cephalosporins keflex cephalexin macrolides e-mycin erythromycin , biaxin clarithromycin , zithromax azithromycin penicillins amoxicillin and penicillin sulfonamides bactrim co-trimoxazole and proloprim trimethoprim tetracyclines sumycin tetracycline and vibramycin doxycycline fluoroquinolones cipro ciprofloxacin , levaquin levofloxacin , floxin ofloxacin .
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Minocycline has an increased risk of severe adverse effects compared to doxycyclineso it best to avoid minocycline as a first-line agentThese include:
Do not use this medication if you are allergic to tetracyclineor to similar medicines such as demeclocyclineDeclomycindoxycyclineAdoxaDoryxOraceaVibramycinor minocyclineDynacinMinocinSolodynVectrin
There are no practical observations suggesting their bioaccumulation in natural conditions.
The most common mechanism by which microbes become resistant to tetracyclines is decreased accumulation of drug into previously susceptible organismsTwo mechanisms include 1impaired uptake into bacteriawhich occurs in mutant strains that do not have the necessary transport systemand 2the much more common plasmidor transposon-mediated acquisition of active efflux pumpsThe genomes for these capabilities may be transferred either by transductionas in Staphylococcus aureusor by conjugationas in many enterobacteriaA second mechanism of resistance is the production of aprotectiveprotein that acts by either preventing bindingdislodging the bound drugor altering the negative impact of binding on ribosomal functionAmong the tetracyclinestigecycline is characterized by less resistance due to efflux or ribosomal protectionRarelytetracyclines can be destroyed by acetylationResistance develops slowly in a multistep fashion but is widespread because of the extensive use of low concentrations of tetracyclines.
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