Minocycline therapy for traumatic wound infections caused by the multidrug-resistant Acinetobacter baumannii-Acinetobacter calcoaceticus complex

The Acinetobacter baumannii-Acinetobacter calcoaceticus complex has become an important cause of traumatic wound infections in US Army soldiers injured in Iraq. Treatment options for these infections are limited by the organism's ability to acquire broad antimicrobial resistance. Alternative antimicrobial agents that are safe and well tolerated are needed. Minocycline has activity against Acinetobacter and has been used by some in the treatment of pneumonia caused by this pathogen. We report a case series of 8 patients treated with minocycline for traumatic wound infections caused by the multidrug-resistant A. baumannii-A. calcoaceticus complex. Minocycline therapy led to clinical cure for 7 of these patients. The remaining patient experienced adverse effects from minocycline requiring a change in therapy. Minocycline is an alternative agent that may be an effective therapy for multidrug-resistant A. baumannii-A. calcoaceticus complex.