Tigecycline in the treatment of infections from multi-drug resistant gram-negative pathogens.
OBJECTIVE
This observational retrospective study aims to present early experience with tigecycline (TIG) in the treatment of infections due to multi-drug resistant (MDR) microorganisms.


METHODS
Adult patients included, received TIG for >5 days either as monotherapy (M group) or as presumed active monotherapy (PAM group). In the PAM group, all co-administered antimicrobial(s) were resistant in vitro against the targeted pathogen(s) or had been clinically and microbiologically failing after >or=5 days of therapy despite in vitro susceptibility.


RESULTS
Forty-five patients (35 in ICU) were treated for 28 Acinetobacter baumannii and 23 Klebsiella pneumoniae infections [21 ventilator-associated and healthcare-acquired pneumonia (VAP/HCAP), 10 bloodstream infections (BSI) and 14 surgical infections (SI)]. Successful overall clinical outcome was 80%, i.e. 81.8% in M group, 78.3% in PAM group, 90.5% in VAP/HCAP, 80% in BSI, 64.3% in SI and 85% in the cases with septic shock. Superinfections from Enterobacteriaceae inherently resistant to tigecycline occurred in 31.8% of M and 13% of PAM group (p<0.001).


CONCLUSIONS
TIG represents a promising option in infections from MDR pathogens, however, further clinical experience is required.
Poulakou
Garyphallia
G
4th Department of Internal Medicine, Athens University School of Medicine, ATTIKON University General Hospital of Athens, Athens, Greece.
Kontopidou
Flora V
FV
Paramythiotou
Elisabeth
E
Kompoti
Maria
M
Katsiari
Maria
M
Mainas
Efstratios
E
Nicolaou
Chara
C
Yphantis
Dimitrios
D
Antoniadou
Anastasia
A
Trikka-Graphakos
Eleftheria
E
Roussou
Zoi
Z
Clouva
Phyllis
P
Maguina
Nina
N
Kanellakopoulou
Kyriaki
K
Armaganidis
Apostolos
A
Giamarellou
Helen
H
D000151:Acinetobacter Infections / Q000188:drug therapy / Q000453:epidemiology; D040981:Acinetobacter baumannii / Q000187:drug effects; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy; D016009:Chi-Square Distribution; D003428:Cross Infection / Q000188:drug therapy; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy / Q000453:epidemiology; D007711:Klebsiella pneumoniae / Q000187:drug effects; D016015:Logistic Models; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D008911:Minocycline / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D053717:Pneumonia, Ventilator-Associated / Q000188:drug therapy; D012189:Retrospective Studies; D012772:Shock, Septic / Q000188:drug therapy; D013530:Surgical Wound Infection / Q000188:drug therapy; D000078304:Tigecycline
D000900:Anti-Bacterial Agents; D000078304:Tigecycline; D008911:Minocycline