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

Reygaert, Wanda

doi:10.2147/tcrm.s9117

Cited by 14 publications

(10 citation statements)

References 105 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The glycylcycline antibiotic tigecycline exhibits a broad spectrum of antimicrobial activity, including most clinically relevant multidrug-resistant Gram-positive and -negative pathogens [3,4,5,6,7]. Therefore, tigecycline is a valuable treatment option for severe infections in hospitalized patients [8,9,10,11,12,13,14,15,16,17,18,19]. Reports on increased mortality in patients treated with tigecycline have been discussed controversially.…”

Section: Introductionmentioning

confidence: 99%

Therapy of 1,025 Severely Ill Patients with Complicated Infections in a German Multicenter Study: Safety Profile and Efficacy of Tigecycline in Different Treatment Modalities

Bodmann¹,

Heizmann²,

Eiff

et al. 2012

Chemotherapy

View full text Add to dashboard Cite

This large prospective non-interventional study investigated the effects of tigecycline either as single agent or in combination with other antimicrobial agents in 1,025 patients treated in clinical routine at German hospitals. Sixty-five percent of the patients had APACHE II scores >15, indicating high overall disease severity. Complicated intra-abdominal infections (cIAI) or complicated skin and skin tissue infections (cSSTI) were the most common indications, with Staphylococcus aureus, Enterococcus faecium and Escherichia coli being the most frequently isolated pathogens. Clinical success was reported at the end of tigecycline therapy in 74.2% of the total population, in 75.4% of the cIAI and in 82.2% of the cSSTI patients. The subpopulation (28.0% of the patients) infected with multidrug-resistant pathogens (methicillin-resistant S. aureus, extended-spectrum β-lactamase producers and vancomycin-resistant enterococci) were treated with similar success rates as the overall population. Tigecycline was generally well tolerated. Drug-related adverse events (AEs) were reported in 7.7% of the total population; 2.5% had serious AEs mostly attributable to inefficacy of therapy or deterioration of the disease. Mortality rates were consistent with the types of infection and severity of illness. There was no indication of excessive mortality associated with tigecycline as had been suggested in previously performed meta-analyses. In this large non-interventional study performed in the clinical routine setting, tigecycline achieved favorable clinical success rates in a patient population with high severity of illness and a high prevalence of multidrug-resistant pathogens and showed a good safety and tolerability profile.

show abstract

Section: Introductionmentioning

confidence: 99%

Therapy of 1,025 Severely Ill Patients with Complicated Infections in a German Multicenter Study: Safety Profile and Efficacy of Tigecycline in Different Treatment Modalities

Bodmann¹,

Heizmann²,

Eiff

et al. 2012

Chemotherapy

View full text Add to dashboard Cite

show abstract

“…Polymicrobial infections, such as complicated skin and skin structure and intra-abdominal infections, are responsible for substantial increases in morbidity and lead to a rise in health care expen- ditures (11,12). These infections involve pathogens that require the use of multiple antimicrobials, often complicating patient care and increasing the potential for drug-related adverse effects.…”

Section: Discussionmentioning

confidence: 99%

In Vivo Efficacy of Humanized Ceftaroline Fosamil-Avibactam Exposures in a Polymicrobial Infection Model

Bhalodi

Crandon

Williams³

et al. 2013

Antimicrob Agents Chemother

View full text Add to dashboard Cite

c Although Gram-positive cocci are the most common pathogens in diabetic foot infections, these infections often are polymicrobial. The objective of this study was to assess the efficacy of a simulated human dose of 600 mg ceftaroline fosamil-600 mg avibactam every 8 h as a 1-h infusion in a polymicrobial in vivo murine model. Seven isolates were used (3 methicillin-resistant Staphylococcus aureus [MRSA] isolates, 1 methicillin-susceptible S. aureus [MSSA] isolate, 1 Escherichia coli isolate, 1 Enterobacter cloacae isolate, and 1 Bacteroides fragilis isolate) in various combinations in an immunocompromised polymicrobial tissue infection to assess the efficacy of the simulated regimen. Each infection was comprised of at least one S. aureus isolate with a MIC of 0.25 to 1 g/ml and one Enterobacteriaceae isolate with a MIC of 1 or 4 g/ml. Eight of 16 infections also included B. fragilis, with a MIC of 0.5 g/ml, as a third organism. Efficacy was evaluated after 24 h as the change in log 10 CFU from the level of 0-h controls. Efficacy was seen against all isolate combinations, with at least a 1-log kill against Enterobacteriaceae and a minimum of a 2-log kill against S. aureus and B. fragilis isolates. These bacterial reductions correlate with free drug concentration above the MIC (fT>MIC) produced by the humanized regimen of 100, 86, and 56% at MICs of 1, 2, and 4 g/ml, respectively. The humanized regimen of 600 mg ceftaroline fosamil-600 mg avibactam every 8 h as a 1-h infusion showed predictable efficacy against all infections tested in this model. These data support further clinical investigation of ceftaroline fosamil-avibactam for the treatment of polymicrobial tissue infections. While the majority of skin and soft-tissue infections are caused by Staphylococcus aureus, these infections can be polymicrobial, involving Gram-positive and Gram-negative pathogens (1, 2). Polymicrobial infections are more common in patients with compromised vasculature, such as diabetics. While Gram-positive organisms are often present in newer wounds, such as cellulitis, Gram-negative and anaerobic organisms are often found in patients with chronic wounds that have been previously treated (3). Anaerobic organisms, such as Bacteroides fragilis, are rarely a sole pathogen and are most frequently found in ischemic or necrotic wounds. Failure to initiate appropriate therapy can lead to poor outcomes and the emergence of resistant pathogens, making these infections increasingly difficult to treat. Therefore, empirical therapy for these patients often involves multiple antimicrobials, such as vancomycin, for Gram-positive coverage and a broad-spectrum cephalosporin, such as cefepime, or an extended-spectrum penicillin, such as piperacillin-tazobactam, for Gram-negative coverage.Ceftaroline fosamil, a broad-spectrum antimicrobial indicated for the treatment of complicated skin and skin structure infections, has potent in vitro activity against many Gram-negative and Gram-positive pathogens, including methicillin-resistant S. aureus (MRSA) ...

show abstract

“…A recent Japanese study indicating that overuse of over-the-counter triple antibiotic creams in the treatment of minor cuts and scrapes may influence the emergence of MRSA USA300 raises significant concerns 19. Hospital-acquired (HA) cSSSIs usually involve infection with S. aureus , Pseudomonas aeruginosa , enterococci, Escherichia coli , and other Enterobacteriaceae , with increased prevalence of MRSA observed in hospitals as well as the community 8,11,12…”

Section: Overview Of Complicated Skin and Skin-structure Infectionsmentioning

confidence: 99%

“…Telavancin should also be avoided in patients with cardiac disease and those who undergo routine coagulation tests, since telavancin produces false-positive blood test abnormalities 42. Tigecycline is only bacteriostatic, can cause digestive system side effects, tooth discoloration, acute pancreatitis, and is contraindicated in pregnant women 8,77. Tigecycline must also be used with caution in patients with hepatic impairment or intestinal perforation 78…”

Section: Advantages and Disadvantages Of Ceftaroline In Csssismentioning

confidence: 99%

Ceftaroline in complicated skin and skin-structure infections

Hernandez¹,

Lema²,

Tyring³

et al. 2012

IDR

View full text Add to dashboard Cite

Ceftaroline is an advanced-generation cephalosporin antibiotic recently approved by the US Food and Drug Administration for the treatment of complicated skin and skin-structure infections (cSSSIs). This intravenous broad-spectrum antibiotic exerts potent bactericidal activity by inhibiting bacterial cell wall synthesis. A high affinity for the penicillin-binding protein 2a (PBP2a) of methicillin-resistant Staphylococcus aureus (MRSA) makes the drug especially beneficial to patients with MRSA cSSSIs. Ceftaroline has proved in multiple well-conducted clinical trials to have an excellent safety and efficacy profile. In adjusted doses it is also recommended for patients with renal or hepatic impairment. Furthermore, the clinical effectiveness and high cure rate demonstrated by ceftaroline in cSSSIs, including those caused by MRSA and other multidrug-resistant strains, warrants its consideration as a first-line treatment option for cSSSIs. This article reviews ceftaroline and its pharmacology, efficacy, and safety data to further elucidate its role in the treatment of cSSSIs.

show abstract

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

Cited by 14 publications

References 105 publications

Therapy of 1,025 Severely Ill Patients with Complicated Infections in a German Multicenter Study: Safety Profile and Efficacy of Tigecycline in Different Treatment Modalities

Therapy of 1,025 Severely Ill Patients with Complicated Infections in a German Multicenter Study: Safety Profile and Efficacy of Tigecycline in Different Treatment Modalities

In Vivo Efficacy of Humanized Ceftaroline Fosamil-Avibactam Exposures in a Polymicrobial Infection Model

Ceftaroline in complicated skin and skin-structure infections

Contact Info

Product

Resources

About