Successful salvage therapy with tigecycline after linezolid failure in a liver transplant recipient with MRSA pneumonia.
Pulmonary infections are a significant cause of morbidity and mortality after liver transplantation. Infections with methicillin-resistant Staphylococcus aureus (MRSA) have increased in the last 10 years. Mortality may exceed 80% in liver transplant recipients who develop MRSA pneumonia. A 57-year-old male following living-donor liver transplantation developed a right-sided MRSA pneumonia 6 weeks after transplantation, which required artificial ventilation for 14 weeks. Initially, pneumonia was treated with linezolid. However, after 12 days under current therapy, the infection spread out to both lungs. At that time. we initiated the treatment with tigecycline. Under this therapy, the patient could be cured from MRSA pneumonia and was extubated. We detected no tigecycline related hepatotoxic effect. In conclusion, this case suggests that tigecycline may be useful in the salvage therapy of pneumonia due to MRSA after linezolid failure.
Saner
Fuat H
FH
Department of General Surgery and Transplantation, University Essen, Germany. fuat.saner@uni-essen.de
Heuer
Matthias
M
Rath
Peter-Michael
PM
Gensicke
Julia
J
Radtke
Arnold
A
Drühe
Nina
N
Rüngeler
Eva-Marija
EM
Nadalin
Silvio
S
Malagó
Massimo
M
Broelsch
Christoph E
CE
D000081:Acetamides / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000627:therapeutic use; D006801:Humans; D000069349:Linezolid; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D008911:Minocycline / Q000031:analogs & derivatives* / Q000627:therapeutic use; D023303:Oxazolidinones / Q000627:therapeutic use*; D011023:Pneumonia, Staphylococcal / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D016879:Salvage Therapy; D013211:Staphylococcus aureus / Q000502:physiology; D000078304:Tigecycline; D017211:Treatment Failure; D016896:Treatment Outcome
D000081:Acetamides; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D023303:Oxazolidinones; D000078304:Tigecycline; D008911:Minocycline; D000069349:Linezolid