title: Tigecycline in the management of post-neurosurgical spondylodiscitis: a review of eight cases.
abstract: BACKGROUND
  Tigecycline is a relatively new glycylcycline antimicrobial, active in vitro against a variety of Gram-positive and Gram-negative organisms. In this study we evaluated the outcomes of spondylodiscitis cases treated with tigecycline-including therapies retrospectively.
  
  
  METHODS
  All adult (age >18 years) cases with a diagnosis of spondylodiscitis, who were treated with a tigecycline-including therapy between 2007 and 2011, were included in the study. The primary efficacy outcome was clinical success with tigecycline at the end of induction, while the secondary efficacy outcome was maintenance of success through 3 months following completion of induction.
  
  
  RESULTS
  A total of eight spondylodiscitis cases fulfilled the study inclusion criteria. All cases had back pain, restricted mobility, magnetic resonance findings associated with spondylodiscitis, and microbiology or pathological findings related to spondylodiscitis. All had post-neurosurgical spondylodiscitis. In five cases, tigecycline was started in accordance with the antibacterial susceptibility results from intervertebral tissue biopsy cultures, whereas in three it was started empirically. All cases had received several different antibacterials with failure before receiving tigecycline. The mean duration of tigecycline treatment was 37±21 days. One case was lost to follow-up after 2 days of tigecycline. Primary and secondary success was achieved in the remaining seven cases.
  
  
  CONCLUSIONS
  These limited data suggest that tigecycline may have a role in the treatment of refractory spondylodiscitis cases.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, Bornova, Izmir, Turkey. Electronic address: Oguz.resat.sipahi@ege.edu.tr.
authors.forename: Oguz Resat
authors.initials: OR
authors.lastname: Sipahi
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, Bornova, Izmir, Turkey.
authors.forename: Hasip
authors.initials: H
authors.lastname: Kahraman
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, Bornova, Izmir, Turkey.
authors.forename: Sinan
authors.initials: S
authors.lastname: Mermer
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, Bornova, Izmir, Turkey.
authors.forename: Husnu
authors.initials: H
authors.lastname: Pullukcu
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, Bornova, Izmir, Turkey.
authors.forename: Meltem
authors.initials: M
authors.lastname: Tasbakan
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, Bornova, Izmir, Turkey.
authors.forename: Bilgin
authors.initials: B
authors.lastname: Arda
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, Bornova, Izmir, Turkey.
authors.forename: Tansu
authors.initials: T
authors.lastname: Yamazhan
authors.affiliation: Department of Neurosurgery, Ege University Faculty of Medicine, Bornova, Izmir, Turkey.
authors.forename: Taskin
authors.initials: T
authors.lastname: Yurtseven
authors.affiliation: Department of Microbiology and Clinical Microbiology, Ege University Faculty of Medicine, Bornova, Izmir, Turkey.
authors.forename: Sohret
authors.initials: S
authors.lastname: Aydemir
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, Bornova, Izmir, Turkey.
authors.forename: Sercan
authors.initials: S
authors.lastname: Ulusoy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D015299:Discitis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000188:drug therapy*; D012189:Retrospective Studies; D000078304:Tigecycline; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000078304:Tigecycline; D002097:C-Reactive Protein; D008911:Minocycline
keywords: Acinetobacter baumannii; Carbapenem-resistant; Healthcare-associated infection; Hospital-acquired; Nosocomial; Spondylitis