Tigecycline in the treatment of ventilator-associated pneumonia: experience from the Latin American Tigecycline Use Registry.
OBJECTIVE
The aim of this study was to evaluate the clinical success rate of the patients with ventilator-associated pneumonia (VAP) treated with tigecycline.


METHODS
Data from patients with established criteria of VAP were collected using a web-based reporting system from 16 February, 2006 to June 23, 2009. One hundred and seventeen patients coming from 10 ICUs from Argentina were studied.


RESULTS
Overall, attending physician reported clinical success in 74 patients (63%; 95%CI 54.08-72.41%). Global mortality proportion was 33% (39/117 patients). Patients with APACHE II score at admission > or = 15 showed a clinical success rate significantly lower and a mortality rate significantly higher than those with APACHE II score at admission less than 15 (52.6% [30/57] vs 73.3% [44/60]; p 0.0332, and 45.6% [26/57]vs 21.7% [13/60]; p 0.0108). The etiology of VAP was established in 60 patients (51%). Acinetobacter spp. (59%; in 84% of cases carbapenems-resistant), and methicillin-resistant Staphylococcus aureus (22%) were the most common microorganisms isolated. Eleven patients (1.5%) had VAP with bacteremia (respiratory sample and blood cultures positive for the same pathogens).


CONCLUSIONS
As initial evidence, our results suggest that tigecycline may be an acceptable alternative for therapy in patients with VAP. Nevertheless, only controlled clinical trials will provide the evidence to support approval for new indications.
Curcio
Daniel
D
Instituto Sacre Cour, Infectologia Institucional SRL, Paraguay 3128 (1425), Buenos Aires, Argentina.
Castagnino
Jorge
J
Vazquez
Walter
W
Vergara
Gabriel
G
Curiale
Ariel
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004341:Drug Evaluation; D024901:Drug Resistance, Multiple, Bacterial; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D017052:Hospital Mortality; D006753:Hospital Records / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007843:Latin America / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000031:analogs & derivatives* / Q000627:therapeutic use; D053717:Pneumonia, Ventilator-Associated / Q000188:drug therapy* / Q000453:epidemiology; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data; D000078304:Tigecycline; D016896:Treatment Outcome; D055815:Young Adult
D000900:Anti-Bacterial Agents; D000078304:Tigecycline; D008911:Minocycline