Tigecycline in the management of osteomyelitis: a case series from the bone and joint infection (BAJIO) database

Griffin, Allen T.; Harting, Julie; Christensen, Diana

doi:10.1016/j.diagmicrobio.2013.07.014

Cited by 20 publications

(12 citation statements)

References 16 publications

(25 reference statements)

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“…Tigecycline is therefore a reasonable option for treatment of bone infections associated with carbapenem-resistant Gram-negative bacilli. [24] Experience with tigecycline in this setting is somewhat limited, as it is not formally indicated for MDR A. baumannii complex osteomyelitis.…”

Section: Discussionmentioning

confidence: 99%

Tigecycline Versus Colistin in the Treatment of Carbapenem-resistant Acinetobacter baumannii Complex Osteomyelitis

Oliveira

Carvalho

Saconi

et al. 2020

J. Bone Joint Infect.

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Abstract. Background: Acinetobacter baumannii complex is an increasingly important cause of osteomyelitis. It is considered a difficult to treat agent, due to increasing antimicrobial resistance and few available therapeutic options.Objective: To compare effectiveness and tolerability of tigecycline and colistin in patients with osteomyelitis caused by carbapenem-resistant A. baumannii complex (CRABC).Methods: This retrospective review included all patients admitted to a 150-bed tertiary hospital from 2007 to 2015 with microbiologically confirmed CRABC osteomyelitis for which they received tigecycline or colistin. Data on demographic and clinical characteristics, adverse events, and outcomes 12 months after the end of antimicrobial treatment were analysed and stratified according to the antimicrobial used.Results: 65 patients were included, 34 treated with colistin and 31 with tigecycline. There were significantly more men (P = 0.028) in the colistin group, and more smokers (P = 0.021) and greater occurrence of chronic osteomyelitis (P = 0.036) in the tigecycline treatment group. Median duration of therapy was 42.5 days for colistin and 42 days for tigecycline, with no significant difference. Overall incidence of adverse events was higher in the colistin group (P = 0.047). In particular, incidence of renal impairment was also higher in this group (P = 0.003). Nausea and vomiting were more frequent with tigecycline (P = 0.046). There were no significant differences between groups in relapse, amputation, or death.Conclusions: Tigecycline had a better safety profile than colistin in the treatment of osteomyelitis due to CRABC, with no significant difference in outcomes after 12 months of follow-up.

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Section: Discussionmentioning

confidence: 99%

Tigecycline Versus Colistin in the Treatment of Carbapenem-resistant Acinetobacter baumannii Complex Osteomyelitis

Oliveira

Carvalho

Saconi

et al. 2020

J. Bone Joint Infect.

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“…The median length of treatment was 6 weeks. Of the patients, 47% experienced some adverse event with the most prevalent being gastrointestinal in nature and five patients required discontinuation of treatment [11]. In another study by De Pascale et al ., a high dose of tigecycline was evaluated in critically ill patients with severe infections due to MDR bacteria [12].…”

Section: Discussionmentioning

confidence: 99%

Prolonged and high dosage of tigecycline – successful treatment of spondylodiscitis caused by multidrug-resistant Acinetobacter baumannii: a case report

et al. 2017

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BackgroundThe incidence of infectious spondylodiscitis has been increasing over the last few years. This reflects the expanding elderly and immunocompromised populations and the rising implementation of invasive spinal procedures. Infection may be inoculated into the disc space directly during invasive spinal procedures. Osteomyelitis caused by Acinetobacter species is rare and mainly caused by multidrug-resistant strains.Case presentationWe present the case of a 72-year-old Greek woman with postoperative spondylodiscitis caused by a multidrug-resistant Acinetobacter baumannii strain that was successfully treated, after she declined surgical treatment, with prolonged and high dosage of tigecycline. She received intravenously administered tigecycline 200 mg per day for 60 days and then 100 mg per day for a total of 102 days and was infection-free.ConclusionsWe reviewed the literature on the role of Acinetobacter baumannii as a cause of osteomyelitis, emphasizing the difficulty of treatment and the potential role of tigecycline in conservative treatment of the infection. We believe that 102 days in total is the longest time that any patient has received tigecycline in the literature, thus our patient is a unique case of successful treatment of spondylodiscitis.

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“…It has yet to find its place as a primary monotherapy for staphylococcal infections. Yet its excellent activity against MRSA and its penetration into bone and biofilm suggest that it may come to be useful as monotherapy or in combination therapy for infected wounds, diabetic foot infections, and osteomyelitis but not pneumonias 15 .…”

Section: Tigecyclinementioning

confidence: 99%

The treatment of resistant staphylococcal infections

John

2020

F1000Res

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Staphylococcus aureus of the many staphylococcal species is the most common cause of both skin and soft tissue infection and severe staphylococcal infections including Staphylococcus aureus bacteremia (SAB). Many antibiotics are active against the staphylococci, yet over the last 40 years antibiotic resistance, particularly resistance to beta-lactam antibiotics, has plagued antimicrobial therapy. The term “methicillin resistance” is a historic term and now refers to the ability of staphylococci, in particular methicillin-resistant Staphylococcus aureus (MRSA), to resist the action of beta-lactam antibiotics. This resistance is encoded by the mecA gene carried in a complex genetic cassette, SCCmec. Vancomycin and old antibiotics remain the keystone of treatment for resistant staphylococci. Other newer agents, and some older agents, show good activity against resistant staphylococci which are the focus of this review: trimethoprim-sulfamethoxazole, ceftaroline, daptomycin, fosfomycin, linezolid, dalbavancin, televancin, and omadacycline. Other agents with novel mechanisms of action are under development, for use as single anti-staphylococcal agents or for combination use to augment the action of the primary anti-staphylococcal agent. Vancomycin therapy carries specific risks, particularly renal dysfunction, but despite its foibles, vancomycin remains the standard of care for the treatment of resistant staphylococcal infections. Some clinicians implement an early switch from vancomycin at the earliest signs of renal dysfunction. The near horizon holds promise also of augmentation of both cellular and humoral responses to staphylococcal infection. Pending newer clinical trials that show clear superiority of one anti-staphylococcal agent over another or over vancomycin, it will remain to expert clinical judgment in determining antibiotic choice and duration of anti-staphylococcal therapy.

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Tigecycline in the management of osteomyelitis: a case series from the bone and joint infection (BAJIO) database

Cited by 20 publications

References 16 publications

Tigecycline Versus Colistin in the Treatment of Carbapenem-resistant Acinetobacter baumannii Complex Osteomyelitis

Tigecycline Versus Colistin in the Treatment of Carbapenem-resistant Acinetobacter baumannii Complex Osteomyelitis

Prolonged and high dosage of tigecycline – successful treatment of spondylodiscitis caused by multidrug-resistant Acinetobacter baumannii: a case report

The treatment of resistant staphylococcal infections

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