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.
4th Department of Internal Medicine, Athens University School of Medicine, ATTIKON University General Hospital of Athens, Athens, Greece.
Garyphallia
G
Poulakou
Flora V
FV
Kontopidou
Elisabeth
E
Paramythiotou
Maria
M
Kompoti
Maria
M
Katsiari
Efstratios
E
Mainas
Chara
C
Nicolaou
Dimitrios
D
Yphantis
Anastasia
A
Antoniadou
Eleftheria
E
Trikka-Graphakos
Zoi
Z
Roussou
Phyllis
P
Clouva
Nina
N
Maguina
Kyriaki
K
Kanellakopoulou
Apostolos
A
Armaganidis
Helen
H
Giamarellou
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