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Minocycline (Minocin) versus ...

Minocycline vs. Tetracycline

Acne

Clinical studies3-4 show that the effect of minocycline is not stronger than tetracycline, but the action is quicker and more sustained than that of tetracycline.

Minocycline may be effective for patients with tetracycline-recalcitrant acne vulgaris. It has much greater antibacterial activity against both Staphylococci and Propionibacterium acnes and produces less resistance than tetracycline1-2.

Urethritis

Minocycline and tetracycline are similarly effective in the treatment of non-gonococcal urethritis6.

In comparative study5 61 of 77 (79%) men treated with tetracycline and 53 of 68 (78%) men treated with minocycline were free from urethritis one to two weeks after completing treatment. Both agents were clinically effective against C trachomatis, but activity against U urealyticum was less consistent. Side effects were noted in 14 (18%) men treated with tetracycline and eight (12%) men treated with minocycline; they were predominantly gastrointestinal.

Minocycline vs. Cephalexin

Prostatitis

Minocycline appears to be more effective than cephalexin in the treatment of acute or chronic prostatitis.

In the multicenter study7 42 men received minocycline (200-mg initially followed by 100 mg twice daily) and 44 cephalexin (500 mg four times daily) for four weeks. Evaluable data were available for 20 minocycline-treated patients and for 24 cephalexin-treated patients. Improvement in symptoms was seen in 65% of the patients who received minocycline and in 46% of those given cephalexin. Bacteriologic cure without relapse or reinfection occurred in 45% of the minocycline-treated men and in 21% of the cephalexin-treated men. Serious adverse clinical experiences were not encountered in either group.

Minocycline vs. Lymecycline (Tetralysal)

Minocycline and lymecycline are similarly effective for inflammatory acne. There is recent evidence that lymecycline is somewhat more effective than minocycline in reducing the number of non-inflammatory acne 9, 10.

A trial8 involving patients with moderate to moderately severe acne vulgaris, found that minocycline (100 mg daily for 4 weeks followed by 50 mg daily for 8 weeks) was superior to lymecycline (300 mg daily for 12 weeks) in the reduction of the number of lesions.

However, in clinical trials, the proportion of people who perceived their appearance to have improved was greater with lymecycline9. For example, these numbers were 65% (44 out of 68) with minocycline and 86% (57 out of 66) with lymecycline. Also, lymecycline was somewhat better in improving non-inflammatory lesions (median percents were 47% for minocycline and 54% for lymecycline).

Results of comparison of minocycline microgranules vs lymecycline in mild to moderate acne 10
Minocycline
Lymecycline
Regimen 100 mg daily for 8 weeks 300 mg daily for 8 weeks
Non-inflammatory lesions count change from 37.5 ± 17.8 to 37.7 ± 17.8 from 36.9 ± 15.5 to 33.4 ± 19.3
Inflammatory lesions count change from 19.4 ± 12.4 to 12.2 ± 10.0 from 20.1 ± 11.3 to 12.6 ± 8.4
Porphyrin counts (bacterial excretions) from 899.5 ± 613.9 to 233.5 ± 219.5 956.9 ± 661.8 to 411.8 ± 411.5
Adverse effects 42.9% patients had 55 adverse events 33.3% patients had 37 adverse events

Further reading

References
  • 1. Eady EA, Cove JH, Holland KT, Cunliffe WJ. Superior antibacterial action and reduced incidence of bacterial resistance in minocycline compared to tetracycline-treated acne patients. Br J Dermatol. 1990 Feb;122(2):233-44. PubMed
  • 2. Eady EA, Jones CE, Gardner KJ, Taylor JP, Cove JH, Cunliffe WJ. Tetracycline-resistant propionibacteria from acne patients are sensitive to minocycline. Br J Dermatol. 1993 May;128(5):556-60.
  • 3. Hubbell CG, Hobbs ER, Rist T, White JW Jr. Efficacy of minocycline compared with tetracycline in treatment of acne vulgaris. Arch Dermatol. 1982 Dec;118(12):989-92. PubMed
  • 4. Samuelson JS. An accurate photographic method for grading acne: initial use in a double-blind clinical comparison of minocycline and tetracycline. J Am Acad Dermatol. 1985 Mar;12(3):461-7. PubMed
  • 5. Oriel JD, Ridgway GL. Comparison of tetracycline and minocycline in the treatment of non-gonococcal urethritis. Br J Vener Dis. 1983 Aug;59(4):245-8 PubMed
  • 6. Turnbull BC, Stringer HC, Meech RJ. Tetracycline and minocycline in the management of non-gonococcal urethritis: a comparison. N Z Med J. 1982 Jul 14;95(711):460-2.
  • 7. Paulson DF, Zinner NR, Resnick MI, Childs SJ, Love T, Madsen PO. Treatment of bacterial prostatitis. Comparison of cephalexin and minocycline. Urology. 1986 Apr;27(4):379-87. PubMed
  • 8. Piérard-Franchimont C, Goffin V, Arrese JE, Martalo O, Braham C, Slachmuylders P, Piérard GE. Lymecycline and minocycline in inflammatory acne: a randomized, double-blind intent-to-treat study. S Pharmacol Appl S Physiol. 2002 Mar-Apr;15(2):112-9. PubMed
  • 9. Bossuyt L, Bosschaert J, Richert B, Cromphaut P, Mitchell T, Al Abadie M, Henry I, Bewley A, Poyner T, Mann N, Czernielewski J. Lymecycline in the treatment of acne. Eur J Dermatol. 2003 Mar-Apr;13(2):130-5. PubMed
  • 10. Ocampo-Candiani J, Velazquez-Arenas LL, de la Fuente-Garcia A, Trevino-Gomezharper C, Berber A. Safety and Efficacy Comparison of Minocycline Microgranules vs Lymecycline in the Treatment of Mild to Moderate Acne: Randomized, Evaluator-blinded, Parallel, and Prospective Clinical Trial for 8 Weeks. J Drugs Dermatol. 2014 Jun 1;13(6):671-6. PubMed
  • 11.

Published: March 31, 2008
Last updated: July 24, 2014

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