Efficacy of tigecycline for the treatment of complicated intra-abdominal infections in real-life clinical practice from five European observational studies

Montravers, Philippe; Bassetti, Matteo; Dupont, Hervé; Eckmann, Christian; Heizmann, W.; Guirao, Xavier; García, Miguel Sánchez; Capparella, Maria Rita; Simoneau, Damien; Bodmann, Klaus Friedrich

doi:10.1093/jac/dkt142

Cited by 50 publications

(31 citation statements)

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“…A few large observational studies have been set up to determine the outcomes of ICU tigecycline-treated patients in clinical practice. The success rates obtained in the current study are in line with those reported in previous registries [13–15, 18] and in the European registry [17–19]. Interestingly, the success rate is also comparable to those reported in RCTs assessing the efficacy of other antibiotics in the ICU setting [36].…”

Section: Discussionsupporting

confidence: 90%

Tigecycline use in critically ill patients: a multicentre prospective observational study in the intensive care setting

et al. 2014

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PurposeThis prospective observational study aimed at describing prescription patterns of tigecycline and patient outcomes in 26 French intensive care units (ICU).MethodsData of consecutive cases of adult patients treated with tigecycline were collected from the initiation until 7 days after the end of treatment. Response to treatment was classified as success, failure or undetermined and analyses were presented according to severity (SOFA score <7 or ≥7). Survival was recorded at 28 days.ResultsA total of 156 patients were included (64 % male, age 60 ± 15 years). At inclusion, 53 % had a SOFA score ≥7; 93 % had received prior anti-infective agents. Tigecycline was given as first-line treatment in 47 % of patients, mostly in combination (67 %), for intra-abdominal (IAI 56 %), skin and soft tissue (SSTI 19 %) or other infections. A total of 76 % of the treated infections were hospital-acquired. Bacteraemia was reported in 12 % of patients. Median treatment duration was 9 days. Tigecycline was prematurely stopped in 42 % patients. The global success rate was 60 % at the end of treatment, and significantly higher with treatment duration more than 9 days (76 vs. 47 %, P < 0.001). Success rate was 65 % for patients alive at the end of treatment. Success rates tended to decrease with illness severity, immunosuppression, bacteraemia and obesity. Survival rate at day 28 was 85 % in the whole cohort and significantly higher in the less severely ill patients (P < 0.001).ConclusionsTigecycline success rates appear comparable to those reported in clinical studies in ICU with severe infections. Tigecycline could be an alternative in ICU patients.Electronic supplementary materialThe online version of this article (doi:10.1007/s00134-014-3323-7) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 90%

Tigecycline use in critically ill patients: a multicentre prospective observational study in the intensive care setting

et al. 2014

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“…Although tigecycline does not feature in vitro activity against P. aeruginosa or certain Enterobacteriaceae ( Proteus spp., Serratia spp., Morganella morganii , Providencia stuartii ), it is still an option for complicated IAIs because of its favorable in vitro activity against anaerobic organisms, enterococci, several ESBLs, and some strains of carbapenemase-producing Enterobacteriaceae [177, 178]. Because of poor plasma concentrations, tigecycline performs poorly in bacteremic patients, with a much higher risk of failing to clear bacteremia [179].…”

Section: What Is the Impact Of The Antimicrobial Resistance In Iais mentioning

confidence: 99%

“…Options for treating vancomicyn-resistant enterococcus infections are linezolid or tigeciclyine [178, 190]. …”

Section: What Is the Impact Of The Antimicrobial Resistance In Iais mentioning

confidence: 99%

Management of intra-abdominal infections: recommendations by the WSES 2016 consensus conference

et al. 2017

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This paper reports on the consensus conference on the management of intra-abdominal infections (IAIs) which was held on July 23, 2016, in Dublin, Ireland, as a part of the annual World Society of Emergency Surgery (WSES) meeting. This document covers all aspects of the management of IAIs. The Grading of Recommendations Assessment, Development and Evaluation recommendation is used, and this document represents the executive summary of the consensus conference findings.

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“…Tigecycline, which has shown in vitro activity against Acinetobacter species in skin and soft tissue infections45 as well as in complicated intra-abdominal infections,46 could be used as alternative therapy for CRAB infections. However, the use of tigecycline in patients with CRAB infections is limited, because the two major clinical CRAB infections are hospital-acquired pneumonia and central- catheter-related bloodstream infections.…”

Section: Treatment Optionsmentioning

confidence: 99%

Update on the Epidemiology, Treatment, and Outcomes of Carbapenem-resistantAcinetobacter infections

Kim

et al. 2014

Chonnam Med J

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Carbapenem-resistant Acinetobacter species are increasingly recognized as major nosocomial pathogens, especially in patients with critical illnesses or in intensive care. The ability of these organisms to accumulate diverse mechanisms of resistance limits the available therapeutic agents, makes the infection difficult to treat, and is associated with a greater risk of death. In this review, we provide an update on the epidemiology, resistance mechanisms, infection control measures, treatment, and outcomes of carbapenem-resistant Acinetobacter infections.

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Efficacy of tigecycline for the treatment of complicated intra-abdominal infections in real-life clinical practice from five European observational studies

Abstract: In these real-life studies, tigecycline, alone and in combination, achieved favourable clinical response rates in patients with cIAI with a high severity of illness.

Cited by 50 publications

References 32 publications

Tigecycline use in critically ill patients: a multicentre prospective observational study in the intensive care setting

Tigecycline use in critically ill patients: a multicentre prospective observational study in the intensive care setting

Management of intra-abdominal infections: recommendations by the WSES 2016 consensus conference

Update on the Epidemiology, Treatment, and Outcomes of Carbapenem-resistantAcinetobacter infections

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