Efficacy and safety of tigecycline monotherapy compared with vancomycin-aztreonam in the treatment of complicated skin and skin structure infections in patients from India and Taiwan

Chuang, Yin-Ching; Chang, Chia–Ming; Aradhya, Sacchidanand Sarvajnamurthy; Bheerappa, Nagari; Pai, Vishwanath; Dartois, Nathalie; Jouve, Sylvie; Cooper, Angel

doi:10.1016/j.jmii.2010.04.002

Cited by 15 publications

(6 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After reading the remaining 170 full-text papers, 121 studies were excluded for the following reasons: studies with an irrelevant study design (n = 46), non-RCTs (n = 16), lacking outcomes (n = 8), duplication of published articles (n = 6), and review and meta-analysis (n = 46). Finally, 48 studies [27–74] were included in the meta-analysis. The study selection process was performed in accordance with the PRISMA guidelines and Figure 1 showed the PRISMA flow diagram.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of optional parenteral antimicrobial therapy for complicated skin and soft tissue infections: A systematic review and Bayesian network meta-analysis

Liang

et al. 2022

Medicine

View full text Add to dashboard Cite

Background: Skin and soft tissue infections (SSTIs) carry significant economic burden, as well as morbidity and mortality, especially when caused by methicillin-resistant Staphylococcus aureus. This study aims to investigate the efficacy and safety of optional antimicrobial therapy for the treatment of complicated SSTIs (cSSTIs). Methods: We searched PubMed, Medline (Via Ovid SP), Embase (Via Ovid SP), and the Cochrane Central Register of Controlled Trials from their inception to March 22, 2021 for randomized controlled trials (RCTs) that studied the use of optional antimicrobial therapy for cSSTIs. Citations’ screening, study selection, data extraction, and risk of bias assessment were independently performed by 2 authors. The primary outcomes were clinical and microbiological treatment success, and adverse events (AEs) were also assessed. Results: A total of 48 trials covering 24,381 patients assessing 20 types of antimicrobial treatment modalities were included. Overall, omadacycline was associated with the highest beneficial effect on clinical and microbiological treatment success and with the largest rank probability based on surface under the cumulative ranking curve values, avarofloxacin was closely followed. Both had, however, omadacycline was related to moderately safety profiles. Lefamulin ranked as the best option was associated with the lowest risk of severe AEs. Subgroup analysis showed similar results. The quality of primary outcomes was moderate to low. Conclusions: The use of omadacycline was associated with higher rates of clinical and microbiological treatment success for the treatment of cSSTIs, with a relative low risk of AEs. Due to the limitations of the included RCTs, high-quality and well-designed RCTs are needed to further confirm the results.

show abstract

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of optional parenteral antimicrobial therapy for complicated skin and soft tissue infections: A systematic review and Bayesian network meta-analysis

Liang

et al. 2022

Medicine

View full text Add to dashboard Cite

show abstract

“…When a subsequent trial was done with double the dose of tigecycline, tigecycline was similar in efficacy to imipenem for the same disease [4]. Subsequent trials in skin and soft tissue infections (SSTIs) [5][6][7][8], community-acquired pneumonia [9][10][11][12], and intraabdominal infections [13][14][15][16] showed equivalent clinical efficacy for tigecycline and several bactericidal comparators (Supplementary Table 1). A metaanalysis suggested worse outcomes with tigecycline compared to competitors [17].…”

Section: Overall Findingsmentioning

confidence: 99%

Busting the Myth of “Static vs Cidal”: A Systemic Literature Review

Wald-Dickler

Holtom

Spellberg

2017

Clinical Infectious Diseases

121

View full text Add to dashboard Cite

We sought to determine if clinical data validate the dogma that bactericidal antibiotics are more clinically effective than bacteriostatic agents. We performed a systematic literature review of published, randomized, controlled trials (RCTs) that compared a bacteriostatic agent to a bactericidal agent in the treatment of clinical, bacterial infections. Of 56 identified trials published since 1985, 49 found no significant difference in efficacy between bacteriostatic and bactericidal agents. In 6 trials it was found that the bacteriostatic agent was superior to the bactericidal agent in efficacy. Only 1 trial found that the bactericidal agent was superior; in that case, the inferiority of the static agent was explainable by underdosing of the drug based on pharmacokinetic-pharmacodynamic analysis. Thus, virtually all available data from high-quality, RCTs demonstrate no intrinsic superiority of bactericidal compared to bacteriostatic agents. Other drug characteristics such as optimal dosing, pharmacokinetics, and tissue penetration may be more important efficacy drivers.

show abstract

“…33 Furthermore, serious adverse events (19/86 patients) were comparable between the 2 groups; even though 4 fatalities occurred in the Indian cohort, 3 in the tigecycline group, these were considered probably not or definitely not related to the study drugs. 33…”

Section: Clinical Efficacy and Safety Of Tigecyclinementioning

confidence: 84%

“…32 Retrospective analysis of data from 2 international, randomized, double blind studies assessing the safety and efficacy of tigecycline monotherapy in Indian (n = 86) and Taiwanese patients (n = 41) hospitalized with cSSSIs revealed comparable cure rates at the test-of-cure-assessment between tigecycline and vancomycin-aztreonam in the clinically evaluable populations in India (83.3% vs. 75.8%) and the clinical modified intent-to-treat populations (78.6% vs. 66.7%). 33 Nausea and vomiting occurred significantly more frequently with tigecycline in comparison to vancomycin-aztreonam; however, the authors concluded that these adverse events were mild to moderate and controlled with appropriate therapy. 33 Furthermore, serious adverse events (19/86 patients) were comparable between the 2 groups; even though 4 fatalities occurred in the Indian cohort, 3 in the tigecycline group, these were considered probably not or definitely not related to the study drugs.…”

Section: Clinical Efficacy and Safety Of Tigecyclinementioning

confidence: 97%

“…33 Nausea and vomiting occurred significantly more frequently with tigecycline in comparison to vancomycin-aztreonam; however, the authors concluded that these adverse events were mild to moderate and controlled with appropriate therapy. 33 Furthermore, serious adverse events (19/86 patients) were comparable between the 2 groups; even though 4 fatalities occurred in the Indian cohort, 3 in the tigecycline group, these were considered probably not or definitely not related to the study drugs. 33…”

Section: Clinical Efficacy and Safety Of Tigecyclinementioning

confidence: 97%

See 1 more Smart Citation

Tigecycline: Role in the Management of cIAI and cSSTI in the Indian Context

Swaminathan

Kundu

2020

Indian Journal of Clinical Medicine

View full text Add to dashboard Cite

The current millennium has witnessed an increased antimicrobial resistance which poses a mammoth challenge for public health management. This has resulted in an increase in morbidity and mortality, resulting in an increase in financial burden to the patients. A recent analysis from 10 hospitals in India reported that mortality rate increases by 1.57 times in patients suffering from multidrug resistance (MDR) bacterial infections as compared to patients infected with similar but susceptible infections. Due to the emergence of MDR and extensively drug-resistant (XDR) bacteria, most of the broad-spectrum antibiotics have been rendered ineffective. The mortality rate with Gram-negative strains is higher than with Gram-positive strains. Tigecycline is the first in class glycylcycline antibiotic with an expanded broad-spectrum activity. Tigecycline enters bacterial cells through energy-dependent pathways or via passive diffusion, to reversibly bind to the 30S ribosomal subunit. It has potent in vitro activity against Gram-negative carbapenemase producers, except Pseudomonas aeruginosa and Proteus spp. It also has good in vitro activity against Carbapenem-resistant Klebsiella pneumoniae strains. Hence, it is considered as a therapeutic option in XDR isolates. Recent meta-analyses have shown tigecycline to be as effective as its comparators with reducing mortality rates. Due to increased resistance reported in carbapenem-resistant isolates in Indian health-care settings, a colistin/polymyxin B-based combination therapy as a treatment option is being sought. A lower mortality rate has been reported with colistin-based combination therapy in Carbapenem-resistant Enterobacteriaceae-associated infections. Combinations with tigecycline, Fosfomycin, and chloramphenicol have shown to improve treatment outcomes. Tigecycline can be a good alternative in MDR and XDR complicated intra-abdominal and complicated skin and soft tissue infections. Appropriately designed clinical trials in Indian health-care setups will reinforce clinician’s confidence in using tigecycline in complex clinical situations.

show abstract

Efficacy and safety of tigecycline monotherapy compared with vancomycin-aztreonam in the treatment of complicated skin and skin structure infections in patients from India and Taiwan

Abstract: Tigecycline monotherapy is a safe and effective therapy for cSSSIs in geographically distinct populations in Asia.

Cited by 15 publications

References 20 publications

Efficacy and safety of optional parenteral antimicrobial therapy for complicated skin and soft tissue infections: A systematic review and Bayesian network meta-analysis

Efficacy and safety of optional parenteral antimicrobial therapy for complicated skin and soft tissue infections: A systematic review and Bayesian network meta-analysis

Busting the Myth of “Static vs Cidal”: A Systemic Literature Review

Tigecycline: Role in the Management of cIAI and cSSTI in the Indian Context

Contact Info

Product

Resources

About