Restricted
Reserved for highly resistant infections or when significant allergies restrict other options and when there is documented susceptibility.
Associated with more treatment failures than alternatives and excess mortality - Black Box Warning.
Restriction: Restricted to ID expert or designee
Criteria for Use: Complicated intra-abdominal infections due to susceptible multi-drug resistant (MDR) gram-negative organisms but resistant to other broad spectrum antibiotics
Unacceptable Uses:
Advisory:
Avoid or use with caution in patients with tetracycline reactions.
GI side effects very prominent with significant nausea and vomiting.
Tetracycline related adverse events: photosensitivity, acute pancreatiti.
Rash, abnormal liver enzymes.
Oral contraceptives less effective.
Requires Infectious Disease consultation.
Documented safety concerns in bacteremia especially.
Antimicrobial class: Tetracycline derivative
Pregnancy category: D
Average serum half life: 42 hours
Lung penetration: Therapeutic
Biliary penetration: Therapeutic