Clinical and microbiological efficacy of tigecycline for complicated skin-soft-tissue and intra-abdominal infections in a Turkish university hospital

Abstract

Summary Objective: Tigecycline, a new glycylcycline antimicrobial agent, is indicated for the treatment of complicated skin structure infection (cSSTI), intra‐abdominal infection (cIAI) and community acquired pneumonia. We aimed to evaluate the clinical and microbiological data together about tigecycline therapy. Methods: Patients with cIAIs and cSSTIs were included in a prospective, observational follow‐up. Patient follow‐up forms were developed and clinical and microbiological data were recorded. Results: Of the 107 patients, 67 had cSSTIs, 40 had cIAIs. Tigecycline was used empirically in 37.5% of cIAIs and in 50.7% of cSSTIs. In 85.0% of the patients with cIAI and in 73.1% of the patients with cSSTI, clinical and/or microbiological response could be achieved. A drug change was made in 26.9% and 7.5% of the patients with cSSTI and cIAI respectively. Superinfection was detected in 14.9% of the cSSTI and 7.5% of the cIAI patients. Conclusion: As a result, tigecycline can be safely used in the treatment of different infections. Compared with cSSTIs, the treatment response is better and the duration of treatment is shorter in cIAIs. However, MIC value must be determined at any rate if tigecycline is to be used in the treatment of Acinetobacter (MDR Acinetobacter, in particular) infections. Clinical cure and microbiological eradication rate of tigecycline therapy changes according to different clinical diagnosis and microorganism.

Tigecycline salvage therapy for critically ill children with multidrug-resistant/extensively drug-resistant infections after surgery

“…Tigecycline showed high antimicrobial activity against a broad spectrum of pathogens largely resistant to other antibiotic classes (Kresken et al, 2011). The rate of microbiological eradication in the study patients was 82%, higher than prior reports of 8.3-69.7% (Avkan-Oguz et al, 2013;Zhu et al, 2016).…”

An Evaluation of the Effectiveness of Risk Minimization Measures for Tigecycline in the European Union

“…Interpretation of differences in definite and probable superinfection between pre-and post-RMM periods within our study is difficult due to wide confidence intervals around these estimates. With regard to overall proportions of superinfection, in a single-site study of patients in Turkey, superinfection (defined as the eradication of the microorganism that was present at the beginning of the treatment and the isolation of a new causative pathogen after C48 h of treatment) was detected in 14.9% of the cSSTI and 7.5% of cIAI patients [14]. Reasons for differences between rates in that study and our own are unclear but may be related to differences in adjudication criteria or underlying differences in the treated population.…”

Recommendations for Intra-abdominal Infections “Consensus Report”

“…Ancak ülkemizde bugüne kadar intra-abdominal enfeksiyonlar (İAE) için ortak dil oluşturmak adına, önerileri kapsayan bir rehber kullanıma sunulmamıştır. Bunun en önemli nedeni klinikte İAE'lerin tanı ve tedavisi ile ilgili veya İAE tanılı hastalardan elde edilen mikroorganizma duyarlılıklarını değerlendiren laboratuvar çalışmalarının oldukça az sayıda olmasıdır [1,2] . Sadece bazı laboratuvara dayalı mikroorganizma duyarlılık çalışmalarında, toplanan kökenlerin bir kısmı İAE'ye ait etkenler olarak bildirilmektedir [3,4] .…”

“…Ülkemizde de bölgesel direnç verilerinde P. aeruginosa'nın ilk sıralarda olmadığı merkezlerde, hafif ve orta şiddetteki sağlık bakımı ilişkili İAE'lerin tedavisinde, karbapenem kullanımını azaltmak amacıyla ampirik tedavide tigesiklin başlanabilir. İntra-abdominal enfeksiyonlarda ESBL (+) E. coli'nin en sık etken olduğu bir merkezde yapılan çalışmada, malignitesi olan ve komplike İAE tanısıyla izlenen hastaların tedavisinde tigesiklin monoterapisi ile %72,3 kür sağlandığı bildirilmektedir [2] . Ülkemizde İAE tedavisinde MRSA için teikoplanin de seçilebilir.…”