Overview of tigecycline and its role in the era of antibiotic resistance

Abstract

The increasing antimicrobial resistance found in the many clinically important species of bacteria that commonly cause serious and life-threatening diseases presents a difficult challenge for clinicians, especially when an appropriate initial therapy must be chosen. New antibiotics are urgently needed to address the formidable issues associated with infections caused by vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), penicillin-resistant Streptococcus pneumoniae and multidrug-resistant Gram-negative bacteria. The need for new antibiotics that effectively resist antimicrobial mechanisms of resistance has become paramount. Tigecycline is a new antimicrobial agent; it is the first in a new class of antibiotics, the glycylcyclines, with properties conferring the ability to overcome many common resistance mechanisms, thus allowing the use of tigecycline for many serious and life-threatening infections for which the use of other antibiotics is no longer appropriate. Tigecycline is a novel expanded spectrum antibiotic that appears poised to meet the latest bacterial challenges facing clinicians, including the serious and life-threatening infections caused by highly resistant bacteria. Tigecycline, moreover, appears to hold promise as a new, versatile antibiotic that can be chosen for empirical therapy, even as a single agent, for initial therapy of many clinically important infections.

Destruction of spirochete Borrelia burgdorferi round-body propagules (RBs) by the antibiotic Tigecycline

“…TG inhibits translation of bacterial proteins by binding both small and large ribosomal subunits of bacterial ribosomes (39)(40)(41)(42).…”

Inhibition of Corneal Neovascularization by Topical and Subconjunctival Tigecycline

“…Several reports have demonstrated the clinical efficacy of derivatives of the tetracycline family on the reduction of corneal neovascularization via downregulation of MMP-9 expression [19–23]. However, in the literature no clinical studies have investigated the clinical efficacy of tigecycline for inhibiting corneal neovascularization.…”

Antibiotic optimization in the difficult-to-treat patient with complicated intra-abdominal or complicated skin and skin structure infections: focus on tigecycline

“…There were a few bacteria that exhibited a reduced susceptibility, and tigecycline monotherapy is probably not recommended for them. Those organisms include Proteus mirabilis , the indole-positive Proteeae ( Proteus vulgaris, Morganella morganii, Providentia species), and P. aeruginosa when isolated from the lungs of cystic fibrosis patients 100,101,109. It is also not recommended to use for pregnant or nursing women as the tetracycline drugs can cross the placenta and may be present in high concentrations in breast milk 99 Table 4.…”