Effectiveness and Safety of Tigecycline Compared with Other Broad‐Spectrum Antimicrobials in Abdominal Solid Organ Transplant Recipients with Polymicrobial Intraabdominal Infections

Abstract

Patients receiving tigecycline were less likely to achieve optimal clinical outcomes and had more adverse events. Alternative regimens should be selected over tigecycline for the treatment of polymicrobial IAIs in abdominal SOT recipients until additional studies are completed to examine its role in this population.

Antistaphylococcal Efficacy of Cefepime, Meropenem, and Piperacillin-Tazobactam in Patients with Polymicrobial Infection with MSSA Bacteremia or Pneumonia

“…In our 12 bacteremic patients, 10 (83.3%) had microbiologic clearance. Lastly, a retrospective cohort study was conducted to compare tigecycline to TZP, MEM, or FEP with or without vancomycin or daptomycin in solid-organ transplant patients with polymicrobial intra-abdominal infections [ 17 ]. Investigators found that patients treated with TZP, MEM, or FEP were more likely to have clinical cure (72.2% vs. 40.7%, p = 0.008) and less adverse events than tigecycline (9.3% vs. 29.6%, p = 0.026) [ 17 ].…”

“…Currently, there is a lack of literature involving transitioning to monotherapy in polymicrobial infections with MSSA bacteremia or pneumonia. Studies have assessed definitive monotherapy options for patients with diagnosed solely with MSSA bacteremia [ 12 – 14 ], and others have published data on definitive monotherapy in patients with polymicrobial infections [ 15 – 17 ], but no published literature has described clinical outcomes in a cohort of patients who have both MSSA and polymicrobial infections treated with β -lactam monotherapy. The aim of this study is to determine if monotherapy with FEP, MEM, or TZP is an effective antibiotic strategy in patients with MSSA bacteremia or pneumonia that is either polymicrobial or accompanied by one or more coinfections.…”

Extended‐spectrum β‐lactamase‐producing and carbapenem‐resistant Enterobacterales bloodstream infection after solid organ transplantation: Recent trends in epidemiology and therapeutic approaches

“…3 After the publication of this document, a single-center retrospective study found that SOT recipients with polymicrobial IAI treated with tigecycline were less likely to achieve favorable clinical outcomes and experienced more adverse events (AEs) than comparator broad-spectrum agents. 103 On the other hand, KT recipients on CNIs may be at an increased risk of developing tigecycline-induced acute pancreatitis. [104][105][106] Despite its five decades of existence, fosfomycin has recently regained attention due to its unique mode of action-the irreversible inhibition of the first cytoplasmic step of peptidoglycan synthesis-that results in a potent bactericidal activity with minimal cross-resistance with other classes of antibiotics.…”

“…The SET/GESITRA‐SEIMC/REIPI recommendations state that tigecycline may be considered as the combination drug associated with a carbapenem (provided that the MIC value ≤8 mg/L) for non‐urinary CRE infections, whereas monotherapy should be reserved to non‐severe infections 3 . After the publication of this document, a single‐center retrospective study found that SOT recipients with polymicrobial IAI treated with tigecycline were less likely to achieve favorable clinical outcomes and experienced more adverse events (AEs) than comparator broad‐spectrum agents 103 . On the other hand, KT recipients on CNIs may be at an increased risk of developing tigecycline‐induced acute pancreatitis 104–106 …”

Bacterial Infections after Liver Transplantation: Updates in Post-Surgical Infections, Vancomycin-Resistant Enterococcus, and Multi-Drug Resistant Enterobacteriaceae

“…On the other hand, tigecycline achieves high penetration in the biliary tract, making it an ideal option for the treatment of biliary tract infections [95]. However, a recent small study of abdominal transplant recipients (LT:63%, Kidney: 22%) complicated with intra-abdominal infection (VRE was seen in 70% of cases) had higher mortality in the tigecycline group than the other comparators [96].…”