title: Tigecycline in febrile neutropenic patients with haematological malignancies: a retrospective case documentation in four university hospitals.
abstract: OBJECTIVE
  Tigecycline (TGC) is a first-in-class glycylcycline with an expanded spectrum of activity. Although TGC has not been prospectively studied in febrile neutropenia (FN), we observed that occasionally critically ill neutropenic patients unresponsive to other antibiotics were treated with TGC in our departments. The aim of our study was to analyse effectiveness and toxicity of TGC in FN.
  
  
  METHODS
  Data of infectious episodes treated with TGC were retrospectively collected. Baseline data of patients, haematological malignancy, infection and adverse events were documented. Success was defined as defervescence (≥7 days) in the absence of any sign of persistent infection.
  
  
  RESULTS
  Data of 35 patients with haematological malignancies and FN were evaluated. Median duration of neutropenia was 25 days (range 6-69 days). The type of infection was pneumonia in 24 patients, four microbiologically documented infections, three clinically documented infections and four with fever of unknown origin. The TGC was administered after a median of two (range 1-5) prior antibiotic regimens. Treatment was successful in 15 (43 %) patients. In patients with prolonged neutropenia (≥28 days), response was significantly lower (13 vs. 79 %; p =0.001). Eight (23 %) patients died during the fever episode. Grade 3-4 toxicity occurred in five (14 %) patients.
  
  
  CONCLUSIONS
  Our results showed promising response rates to TGC and very low toxicity rates compared to the generally low response rate of third-line antibiotic therapies, indicating that TGC may be a successful alternative for salvage treatment of febrile neutropenia, but further study is needed.
authors: Department of Internal Medicine III, University of Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany, Katjana.Schwab@ukb.uni-bonn.de.
authors: K S
authors: KS
authors: Schwab
authors: C
authors: C
authors: Hahn-Ast
authors: W J
authors: WJ
authors: Heinz
authors: U
authors: U
authors: Germing
authors: G
authors: G
authors: Egerer
authors: A
authors: A
authors: Glasmacher
authors: C
authors: C
authors: Leyendecker
authors: G
authors: G
authors: Marklein
authors: C M
authors: CM
authors: Nellessen
authors: P
authors: P
authors: Brossart
authors: M
authors: M
authors: von Lilienfeld-Toal
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D064146:Chemotherapy-Induced Febrile Neutropenia / Q000188:drug therapy*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000473:pathology; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications / Q000188:drug therapy*; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012189:Retrospective Studies; D000078304:Tigecycline; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000078304:Tigecycline; D008911:Minocycline
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