Retrospective evaluation of colistin versus tigecycline for the treatment of Acinetobacter baumannii and/or carbapenem-resistant Enterobacteriaceae infections

Major Variation in MICs of Tigecycline in Gram-Negative Bacilli as a Function of Testing Method

“…Tigecycline is one of the few available agents that possess antimicrobial activity against these resistant pathogens (9)(10)(11)(12)(13)(14). Tigecycline has a relatively safe therapeutic profile compared to that of other agents that often have activity against these pathogens (e.g., polymyxins and aminoglycosides) (3,15). However, tigecycline has limitations as a therapeutic agent.…”

“…However, tigecycline has limitations as a therapeutic agent. It achieves low serum levels, and data pertaining to the effective treatment of invasive infections with tigecycline are lacking (1)(2)(3)13). Recent meta-analyses and reports from the U.S. Food and Drug Administration have detailed an increased mortality risk among subjects receiving tigecycline in clinical trials (13,14,16).…”

“…Recent meta-analyses and reports from the U.S. Food and Drug Administration have detailed an increased mortality risk among subjects receiving tigecycline in clinical trials (13,14,16). Due to the lack of options, tigecycline is still frequently used for the treatment of clinical infections due to A. baumannii and CRE, often with similar and, in some instances, favorable clinical efficacy compared to that of other available therapeutic options (3).…”

“…nfections due to multidrug-resistant (MDR) and extensively drug-resistant (XDR) Gram-negative bacillus (GNB) pathogens, such as extended-spectrum ␤-lactamase (ESBL)-producing Enterobacteriaceae, Acinetobacter baumannii, and carbapenem-resistant Enterobacteriaceae (CRE), continue to increase worldwide and pose significant management challenges due to the lack of available therapeutic alternatives (1)(2)(3)(4). These infections are associated with devastating outcomes, and they place a huge burden on and threaten the general population (1,2,(5)(6)(7)(8).…”

Antimicrobial Treatment and Containment Measures for an Extremely Drug-Resistant Klebsiella pneumoniae ST101 Isolate Carrying pKPN101-IT, a Novel Fully Sequenced bla KPC-2 Plasmid

“…To date, tigecycline has been successfully used in combination with colistin for the treatment of pandrug-resistant K. pneumoniae (15,23). Unfortunately, antimicrobial administration is not always a synonym of complete eradication of the resistant isolate (22,28).…”