title: Tigecycline use in critically ill patients: a multicentre prospective observational study in the intensive care setting.
abstract: OBJECTIVE
  This prospective observational study aimed at describing prescription patterns of tigecycline and patient outcomes in 26 French intensive care units (ICU).
  
  
  METHODS
  Data of consecutive cases of adult patients treated with tigecycline were collected from the initiation until 7 days after the end of treatment. Response to treatment was classified as success, failure or undetermined and analyses were presented according to severity (SOFA score <7 or ≥7). Survival was recorded at 28 days.
  
  
  RESULTS
  A total of 156 patients were included (64% male, age 60 ± 15 years). At inclusion, 53% had a SOFA score ≥7; 93% had received prior anti-infective agents. Tigecycline was given as first-line treatment in 47% of patients, mostly in combination (67%), for intra-abdominal (IAI 56%), skin and soft tissue (SSTI 19%) or other infections. A total of 76% of the treated infections were hospital-acquired. Bacteraemia was reported in 12% of patients. Median treatment duration was 9 days. Tigecycline was prematurely stopped in 42% patients. The global success rate was 60% at the end of treatment, and significantly higher with treatment duration more than 9 days (76 vs. 47%, P < 0.001). Success rate was 65% for patients alive at the end of treatment. Success rates tended to decrease with illness severity, immunosuppression, bacteraemia and obesity. Survival rate at day 28 was 85% in the whole cohort and significantly higher in the less severely ill patients (P < 0.001).
  
  
  CONCLUSIONS
  Tigecycline success rates appear comparable to those reported in clinical studies in ICU with severe infections. Tigecycline could be an alternative in ICU patients.
authors.affiliation: Department of Anesthesiology and Surgical Intensive Care, Bichat-Claude Bernard University Hospital Center, Paris Diderot University, Sorbonne Paris-Cité and AP-HP, 46 Rue Henri-Huchard, 75018, Paris, France, philippe.montravers@bch.aphp.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Montravers
authors.forename: Hervé
authors.initials: H
authors.lastname: Dupont
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bedos
authors.forename: Philippe
authors.initials: P
authors.lastname: Bret
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy; D016638:Critical Illness; D003428:Cross Infection / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D005602:France / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D016867:Immunocompromised Host; D007239:Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology; D063868:Patient Outcome Assessment; D011446:Prospective Studies; D012720:Severity of Illness Index; D000078304:Tigecycline; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000078304:Tigecycline; D008911:Minocycline