A retrospective observational study of the impact of Tigecycline in treating multidrug resistant pneumonia

Abstract

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Few antimicrobials are currently active to treat extensively drug resistant (XDR) gram-negative bacilli infections. This represents a serious global public health concern. Critically ill patients face the brunt of majority of these infections. Tigecycline has coverage for a majority of these XDR infections (with the exception of <em>Pseudomonas aeruginosa</em>), but is not currently approved for hospital-acquired pneumonia. Nevertheless it is being commonly used for this indication though many meta-analysis have suggested an increased risk of death in patients receiving this antibiotic. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">In this retrospective analysis we compared the mortality rates between a Tigecycline based and a non Tigecycline based therapy for XDR infections in the critically ill over a period of 12 months. A total of 93 patients were included in the study.</span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Tigecycline group had significantly increased risk for in hospital mortality with an odds ratio of 6.0 and 95% CI of 1.37 to 26.12 with a p value of 0.01. But such a difference was not evident in 14 day mortality. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Initiation of Tigecycline for multidrug resistant, pneumonia needs to be re-thought. Only a small percentage of patients with pneumonia with <em>in-vitro</em> sensitivity having low minimum inhibitory concentration (MIC) would benefit from the drug. Even in this group the risk of increased mortality needs to be carefully considered before Initiation of therapy</span>.</p>