Single Daily High-Dose Tigecycline Therapy of a Multidrug-Resistant (MDR)<i>Klebsiella pneumoniae</i>and<i>Enterobacter aerogenes</i>Nosocomial Urinary Tract Infection

Cunha, Burke A.; Mcdermott, B.; Nausheen, Sara

doi:10.1179/joc.2007.19.6.753

Cited by 42 publications

(30 citation statements)

References 10 publications

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“…It generally exhibits bacteriostatic activity against a wide spectrum of aerobic and anaerobic bacteria, including multidrug-resistant (MDR) organisms, but it consistently shows little or no activity against Pseudomonas aeruginosa (6,8,11).…”

mentioning

confidence: 99%

In Vivo Emergence of Tigecycline Resistance in Multidrug-Resistant Klebsiella pneumoniae and Escherichia coli

Spanu

Angelis

Cipriani

et al. 2012

Antimicrob Agents Chemother

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Although resistance to tigecycline has been reported in surveillance studies, very few reports have described the emergence of resistance in vivo. We report two cases of patients with infections due to SHV-12-producing Klebsiella pneumoniae and K. pneumoniae carbapenemase-3 (KPC-3)-producing Escherichia coli, which developed tigecycline resistance in vivo after treatment. The reported limited experience underlines the risk of occurrence of a tigecycline MIC increase under treatment pressure.

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confidence: 99%

In Vivo Emergence of Tigecycline Resistance in Multidrug-Resistant Klebsiella pneumoniae and Escherichia coli

Spanu

Angelis

Cipriani

et al. 2012

Antimicrob Agents Chemother

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“…Evaluations of polymyxin B (20) and tigecycline (2,8,10,14,21) for the treatment of Gram-negative bacterial UTI are limited to case reports. In addition to limited clinical data, pharmacokinetic data raise concerns over the use of polymyxin B and tigecycline for UTI.…”

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confidence: 99%

Comparative Effectiveness of Aminoglycosides, Polymyxin B, and Tigecycline for Clearance of Carbapenem-Resistant Klebsiella pneumoniae from Urine

Satlin

Kubin

Blumenthal

et al. 2011

Antimicrob Agents Chemother

120

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Carbapenem-resistant Klebsiella pneumoniae (CRKP) is an increasingly common cause of health careassociated urinary tract infections. Antimicrobials with in vitro activity against CRKP are typically limited to polymyxins, tigecycline, and often, aminoglycosides. We conducted a retrospective cohort study of cases of CRKP bacteriuria at New York-Presbyterian Hospital from January 2005 through June 2010 to compare microbiologic clearance rates based on the use of polymyxin B, tigecycline, or an aminoglycoside. We constructed three active antimicrobial cohorts based on the active agent used and an untreated cohort of cases that did not receive antimicrobial therapy with Gram-negative activity. Microbiologic clearance was defined as having a follow-up urine culture that did not yield CRKP. Cases without an appropriate follow-up culture or that received multiple active agents or less than 3 days of the active agent were excluded. Eighty-seven cases were included in the active antimicrobial cohorts, and 69 were included in the untreated cohort. The microbiologic clearance rate was 88% in the aminoglycoside cohort (n ‫؍‬ 41), compared to 64% in the polymyxin B (P ‫؍‬ 0.02; n ‫؍‬ 25), 43% in the tigecycline (P < 0.001; n ‫؍‬ 21), and 36% in the untreated (P < 0.001; n ‫؍‬ 69) cohorts. Using multivariate analysis, the odds of clearance were lower for the polymyxin B (odds ratio [OR], 0.10; P ‫؍‬ 0.003), tigecycline (OR, 0.08; P ‫؍‬ 0.001), and untreated (OR, 0.14; P ‫؍‬ 0.003) cohorts than for the aminoglycoside cohort. Treatment with an aminoglycoside, when active in vitro, was associated with a significantly higher rate of microbiologic clearance of CRKP bacteriuria than treatment with either polymyxin B or tigecycline.

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“…For MDR aerobic gram-negative bacteremias, "high-dose" tigecycline may optimize concentration-dependent killing (1). For UTIs, "high-dose" tigecycline provides higher urinary concentrations (2,5).…”

Section: Pharmacokinetic Considerations Regarding Tigecycline For Mulmentioning

confidence: 99%

Pharmacokinetic Considerations regarding Tigecycline for Multidrug-Resistant (MDR) Klebsiella pneumoniae or MDR Acinetobacter baumannii Urosepsis

Cunha

2009

J Clin Microbiol

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Single Daily High-Dose Tigecycline Therapy of a Multidrug-Resistant (MDR)Klebsiella pneumoniaeandEnterobacter aerogenesNosocomial Urinary Tract Infection

Cited by 42 publications

References 10 publications

In Vivo Emergence of Tigecycline Resistance in Multidrug-Resistant Klebsiella pneumoniae and Escherichia coli

In Vivo Emergence of Tigecycline Resistance in Multidrug-Resistant Klebsiella pneumoniae and Escherichia coli

Comparative Effectiveness of Aminoglycosides, Polymyxin B, and Tigecycline for Clearance of Carbapenem-Resistant Klebsiella pneumoniae from Urine

Pharmacokinetic Considerations regarding Tigecycline for Multidrug-Resistant (MDR) Klebsiella pneumoniae or MDR Acinetobacter baumannii Urosepsis

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