title: The efficacy and safety of tigecycline for the treatment of bloodstream infections: a systematic review and meta-analysis.
abstract: Patients with bloodstream infections (BSI) are associated with high mortality rates. Due to tigecycline has shown excellent in vitro activity against most pathogens, tigecycline is selected as one of the candidate drugs for the treatment of multidrug-resistant organisms infections. The purpose of this study was to evaluate the effectiveness and safety of the use of tigecycline for the treatment of patients with BSI. The PubMed and Embase databases were systematically searched, to identify published studies, and we searched clinical trial registries to identify completed unpublished studies, the results of which were obtained through the manufacturer. The primary outcome was mortality, and the secondary outcomes were the rate of clinical cure and microbiological success. 24 controlled studies were included in this systematic review. All-cause mortality was lower with tigecycline than with control antibiotic agents, but the difference was not significant (OR 0.85, [95% confidence interval (CI) 0.31-2.33; P = 0.745]). Clinical cure was significantly higher with tigecycline groups (OR 1.76, [95% CI 1.26-2.45; P = 0.001]). Eradication efficiency did not differ between tigecycline and control regimens, but the sample size for these comparisons was small. Subgroup analyses showed good clinical cure result in bacteremia patients with CAP. Tigecycline monotherapy was associated with a OR of 2.73 (95% CI 1.53-4.87) for mortality compared with tigecycline combination therapy (6 studies; 250 patients), without heterogeneity. Five studies reporting on 398 patients with Klebsiella pneumoniae carbapenemase-producing K. pneumoniae BSI showed significantly lower mortality in the tigecycline arm than in the control arm. The combined treatment with tigecycline may be considered the optimal option for severely ill patients with BSI.
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, 230022, Anhui, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, 230022, Anhui, China.
authors.forename: Yaping
authors.initials: Y
authors.lastname: Pan
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, 230022, Anhui, China. shenjilu@126.com.
authors.forename: Jilu
authors.initials: J
authors.lastname: Shen
authors.affiliation: Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, 230022, Anhui, China.
authors.forename: Yuanhong
authors.initials: Y
authors.lastname: Xu
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy*; D006801:Humans; D008911:Minocycline / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016019:Survival Analysis; D000078304:Tigecycline; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000078304:Tigecycline; D008911:Minocycline