title: Efficacy of tigecycline for the treatment of complicated skin and soft-tissue infections in real-life clinical practice from five European observational studies.
abstract: OBJECTIVE
  Tigecycline is an approved treatment for complicated skin and soft-tissue infections (cSSTIs). The efficacy of tigecycline as monotherapy or in combination with other antibacterials in the treatment of cSSTI in routine practice is described.
  
  
  METHODS
  Individual patient-level data were pooled from five European observational studies (July 2006 to October 2011).
  
  
  RESULTS
  A total of 254 cSSTI patients who received tigecycline were included (mean age 63.2 ± 14.9 years). Of these, 34.4% were in intensive care units, 54.5% acquired their infection in hospital and 90.9% had at least one comorbidity. Infection most commonly affected the limbs (62.4%) and 43.8% of infections were classified as necrotizing. The mean Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores at the beginning of treatment were 15.0 ± 7.9 (n = 205) and 5.8 ± 3.9 (n = 32), respectively, indicating high disease severity. Staphylococcus aureus (52.7%), Escherichia coli (18.0%) and Enterococcus faecium (12.0%) were the most frequently isolated pathogens; 32.9% of infections were polymicrobial and 30.5% were due to resistant pathogens. Overall, 71.8% received tigecycline as monotherapy and 28.2% as combination therapy for a mean duration of 12 days. Clinical response rates at the end of treatment were 79.6% for all patients who received the standard dosage (183/230), 86.7% for patients who received tigecycline as monotherapy (143/165), 75.0% for patients with a nosocomial infection (96/128), 75.3% for patients with an APACHE II score >15 (61/81) and 58.3% for patients with a SOFA score ≥ 7 (7/12).
  
  
  CONCLUSIONS
  In these real-life studies, tigecycline, alone and in combination, achieved favourable clinical response rates in patients with cSSTI with a high severity of illness.
authors.affiliation: Département d'Anesthésie Réanimation, Univ Paris Diderot, Sorbonne Paris Cité and APHP, Centre Hospitalier Universitaire Bichat-Claude Bernard, Paris, France. philippe.montravers@bch.aphp.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Montravers
authors.forename: Matteo
authors.initials: M
authors.lastname: Bassetti
authors.forename: Hervé
authors.initials: H
authors.lastname: Dupont
authors.forename: Christian
authors.initials: C
authors.lastname: Eckmann
authors.forename: Wolfgang R
authors.initials: WR
authors.lastname: Heizmann
authors.forename: Xavier
authors.initials: X
authors.lastname: Guirao
authors.forename: Miguel Sánchez
authors.initials: MS
authors.lastname: García
authors.forename: Maria Rita
authors.initials: MR
authors.lastname: Capparella
authors.forename: Damien
authors.initials: D
authors.lastname: Simoneau
authors.forename: Klaus Friedrich
authors.initials: KF
authors.lastname: Bodmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000379:methods; D005060:Europe; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D006801:Humans; 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: broad-spectrum antibacterial therapy; glycylcycline antibiotics; necrotizing skin infections; non-interventional studies