title: Prescription behaviours for tigecycline in real-life clinical practice from five European observational studies.
abstract: OBJECTIVE
  There is limited information on the use of tigecycline in real-life clinical practice. This analysis aims to identify and understand tigecycline prescribing patterns and associated patient outcomes for approved indications.
  
  
  METHODS
  A pooled analysis of patient-level data collected on the prescription of tigecycline in five European observational studies (July 2006 to October 2011) was conducted.
  
  
  RESULTS
  A total of 1782 patients who received tigecycline were included in the analysis. Of these patients, 61.6% were male, the mean age was 63.4 ± 14.7 years, 56.4% were in intensive care units, 80.2% received previous antibiotic treatment and 91% had one or more comorbid conditions. The mean Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores at the beginning of treatment were 17.7 ± 7.9 and 7.0 ± 4.0, respectively. The majority of patients (58.3%) received tigecycline for treatment of complicated skin and soft-tissue infections (cSSTIs; n = 254) or complicated intra-abdominal infections (cIAIs; n = 785). Tigecycline was given at the standard dose (100 mg plus 50 mg twice daily) to 89.3% of patients for a mean duration of 11.1 ± 6.4 days. The main reasons for prescribing tigecycline were failure of previous therapy (46.1%), broad-spectrum antibiotic coverage (41.4%) and suspicion of a resistant pathogen (39.3%). Tigecycline was prescribed first-line in 36.3% of patients and as monotherapy in 50.4%. Clinical response rates to treatment with tigecycline alone or in combination were 79.6% (183/230; cSSTIs) and 77.4% (567/733; cIAIs).
  
  
  CONCLUSIONS
  Although tigecycline prescription behaviour showed some heterogeneity across the study sites, these results confirm a role for tigecycline in real-life clinical practice for the treatment of complicated infections, including those in critically ill patients, across Europe.
authors.affiliation: Clinica Malattie Infettive, AOU Santa Maria della Misericordia, Udine, Italy. mattba@tin.it
authors.forename: Matteo
authors.initials: M
authors.lastname: Bassetti
authors.forename: Christian
authors.initials: C
authors.lastname: Eckmann
authors.forename: Klaus Friedrich
authors.initials: KF
authors.lastname: Bodmann
authors.forename: Hervé
authors.initials: H
authors.lastname: Dupont
authors.forename: Wolfgang R
authors.initials: WR
authors.lastname: Heizmann
authors.forename: Philippe
authors.initials: P
authors.lastname: Montravers
authors.forename: Xavier
authors.initials: X
authors.lastname: Guirao
authors.forename: Maria Rita
authors.initials: MR
authors.lastname: Capparella
authors.forename: Damien
authors.initials: D
authors.lastname: Simoneau
authors.forename: Miguel
authors.initials: M
authors.lastname: Sánchez García
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005060:Europe; D005260:Female; D006801:Humans; D059413:Intraabdominal Infections / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017192:Skin Diseases, Bacterial / Q000188:drug therapy; D018461:Soft Tissue Infections / Q000188:drug therapy; D000078304:Tigecycline; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000078304:Tigecycline; D008911:Minocycline
keywords: antibacterial prescribing practices; broad-spectrum antibacterial therapy; complicated intra-abdominal infections; complicated skin and soft-tissue infections; non-interventional studies