Versus staph, Minocycline is better because it inhibits protein syntheses by binding to the 30s subunit bacterial ribosomes. It also inhibits mammalian collagenase and to a degree, bacterial collagenase. It is not the drug of choice for patients with renal disease. Generally, this is not clinically significant, but in patients with renal insufficiency, this can result in worsening of the uremic state by increasing the urea and acid load to the kidney. Erythromycin and OMX are poorly concentrated in the sulcus, much less in sulcus than serum.
Gastrointestinal upset includes the usual problems of nausea, vomiting, anorexia, diarrhea, etc.
This is clinically rare. If diarrhea occurs in a patient receiving TCN, PMC must be ruled out. Diarrhea of PMC contains blood or mucous. Also it is associated tiwh abdominal pain and fever. Latter disease due to overgrowth of Clostridium difficile.