title: New uses of older antibiotics.
abstract: Despite the development of extended-spectrum penicillins, cephalosporins, and quinolones, the older antimicrobial agents, doxycycline, minocycline, TMP-SMX, clindamycin, and metronidazole, still play an important role in the treatment of infectious diseases. All of these older drugs are well absorbed by the oral route, attaining serum levels equivalent to those achieved by parenteral administration. The availability of generic forms of the older drugs reduces their cost. Besides traditional uses, some older drugs have become the preferred therapy for newly recognized infectious diseases. Doxycycline is the preferred drug for rickettsial tickborne diseases, ehrlichiosis and early Lyme disease. TMP-SMX is the preferred drug for I. belli and Cyclospora. Minocycline has been used to treat MRSA and MRSE infections. Clindamycin or metronidazole combined with a quinolone is an excellent oral regimen for polymicrobial infections. [table: see text]
authors.affiliation: Department of Medicine, State University of New York School of Medicine, Stony Brook, USA.
authors.forename: N C
authors.initials: NC
authors.lastname: Klein
authors.forename: B A
authors.initials: BA
authors.lastname: Cunha
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000494:pharmacology; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D002701:Chloramphenicol / Q000008:administration & dosage; D002981:Clindamycin / Q000008:administration & dosage; D002986:Clinical Trials as Topic; D004318:Doxycycline / Q000008:administration & dosage; D018432:Drug Resistance, Multiple; D006801:Humans; D008795:Metronidazole; D008826:Microbial Sensitivity Tests; D008911:Minocycline / Q000008:administration & dosage; D011379:Prognosis
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D002981:Clindamycin; D002701:Chloramphenicol; D008911:Minocycline; D004318:Doxycycline