Tigecycline for the treatment of patients with community-acquired pneumonia requiring hospitalization

Abstract

Pneumonia, along with influenza, is the leading cause of mortality associated with infectious diseases in the USA. Tigecycline is a novel antimicrobial agent that is active against a broad spectrum of pathogens. Our objective is to review the literature about the efficacy of tigecycline in community-acquired pneumonia (CAP). Data from various sources, including Pubmed, the European Medicines Agency (EMEA) and the US FDA were appraised. Tigecycline was found to be noninferior compared with levofloxacin for the treatment of patients with bacterial CAP requiring hospitalization. Recently, the drug was approved for the treatment of these patients by the FDA, but owing to some concerns, its application in the EMEA has been withdrawn. In addition, in a recent study concerns were expressed about the efficacy of tigecycline in the lungs using the current dosage. More data are needed about the pharmacokinetics of tigecycline in the lungs and its efficacy in severe CAP.

Tigecycline treatment of multi‐drug‐resistant Corynebacterium jeikeium infection in a child with relapsing and refractory acute lymphoblastic leukemia

“…No data are available on the safety of tigecycline in children. Clinically significant organ toxicity was not observed in clinical trials in adult patients, and the most common adverse effects were gastrointestinal symptoms, such as nausea and vomiting 3–9. Our patient did not experience any tigecycline‐associated adverse effects during her treatment course.…”

“…It can be used to treat various aerobic and anaerobic Gram‐positive and Gram‐negative pathogens as well as atypical pathogens 3–9. It has been approved by the FDA for the treatment of complicated skin and skin–structure infections, complicated intra‐abdominal infections, and community‐acquired pneumonia 3–9. It has also been found to be generally safe and well tolerated in the treatment of secondary bacteremia 18.…”

“…Bacteremia poses a major risk to immunocompromised patients, especially when the causative organism is resistant to multiple antibiotics 2. Tigecycline, first member of the glycyclines, has in vitro activity against a wide variety of organisms, including multi‐drug‐resistant pathogens 1, 3–9. It can also be a good alternative for the treatment of infections caused by Corynebacterium .…”

Comparison of characteristics of outpatients with 2009 H1N1 pandemic and seasonal influenza

“…Indeed, reports on the emergence of pandemic strains resistant to oseltamivir had appeared in the literature during the pandemic period (24–26). On the other hand, considering the alarmingly high rates of antibiotic resistance reported for respiratory pathogens (27–29), a more conservative therapeutic approach with regard to antibiotic treatment to patients with evidence of viral infections, including influenza, may eventually confer considerable benefit from an individual‐patient care, as well from a public health perspective.…”

Microbial isolation and emergence of antimicrobial resistance associated with tigecycline usage

“…1 In 2009, the US Food and Drug Administration (FDA) approved tigecycline for community-acquired pneumonia, as well as for intraabdominal infection (IAI) and skin and soft tissue infection. 2 It is also effective in the treatment of common multidrug-resistant gram-negative bacteria encountered frequently in hospital-acquired infections, including multidrug-resistant Acinetobacter baumannii, 3 Stenotrophomonas maltophilia, 4 and Clostridium difficile, 5 although it is less effective against Pseudomonas aeruginosa, Proteus sp, and Providencia sp. 6 Use of many classes of antimicrobial agents has been shown to be a risk factor for the colonization of or infection by resistant pathogens.…”