The role of tigecycline in the management of Clostridium difficile infection: a retrospective cohort study

Manea, Eliza; Sojo-Dorado, Jesús; Jipa, Raluca; Benea, Șerban; Hristea, Adriana

doi:10.1016/j.cmi.2017.06.005

Cited by 19 publications

(15 citation statements)

References 16 publications

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“…Moreover, three retrospective cohort studies failed to demonstrate a beneficial effect of adjunctive tigecycline CDI treatment on patients outcome in comparison to standard treatment alone ( 145 – 147 ).…”

Section: Resultsmentioning

confidence: 99%

Novel Antimicrobials for the Treatment of Clostridium difficile Infection

2018

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The current picture of Clostridium difficile infection (CDI) is alarming with a mortality rate ranging between 3% and 15% and a CDI recurrence rate ranging from 12% to 40%. Despite the great efforts made over the past 10 years to face the CDI burden, there are still gray areas in our knowledge on CDI management. The traditional anti-CDI antimicrobials are not always adequate in addressing the current needs in CDI management. The aim of our review is to give an update on novel antimicrobials for the treatment of CDI, considering the currently available evidences on their efficacy, safety, molecular mechanism of action, and their probability to be successfully introduced into the clinical practice in the near future. We identified, through a PubMed search, 16 novel antimicrobial molecules under study for CDI treatment: cadazolid, surotomycin, ridinilazole, LFF571, ramoplanin, CRS3123, fusidic acid, nitazoxanide, rifampin, rifaximin, tigecycline, auranofin, NVB302, thuricin CD, lacticin 3147, and acyldepsipeptide antimicrobials. In comparison with the traditional anti-CDI antimicrobial treatment, some of the novel antimicrobials reviewed in this study offer several advantages, i.e., the favorable pharmacokinetic and pharmacodynamic profile, the narrow-spectrum activity against CD that implicates a low impact on the gut microbiota composition, the inhibitory activity on CD sporulation and toxins production. Among these novel antimicrobials, the most active compounds in reducing spore production are cadazolid, ridinilazole, CRS3123, ramoplanin and, potentially, the acyldepsipeptide antimicrobials. These antimicrobials may potentially reduce CD environment spread and persistence, thus reducing CDI healthcare-associated acquisition. However, some of them, i.e., surotomycin, fusidic acid, etc., will not be available due to lack of superiority versus standard of treatment. The most CD narrow-spectrum novel antimicrobials that allow to preserve microbiota integrity are cadazolid, ridinilazole, auranofin, and thuricin CD. In conclusion, the novel antimicrobial molecules under development for CDI have promising key features and advancements in comparison to the traditional anti-CDI antimicrobials. In the near future, some of these new molecules might be effective alternatives to fight CDI.

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Section: Resultsmentioning

confidence: 99%

Novel Antimicrobials for the Treatment of Clostridium difficile Infection

2018

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“…These data support the use of tigecycline in complicated and severe C difficile infection. Two retrospective studies confirm the safety of the drug in severely infected patients118 but failed to show an improvement compared with standard therapy in clinical cure or recurrence rate 119. If tigecycline is used to treat severe infections, it should be considered a substitute to metronidazole as adjunctive therapy to vancomycin.…”

Section: Treatmentmentioning

confidence: 99%

Clostridioides difficile: diagnosis and treatments

Guery

Galpérine

Barbut

2019

BMJ

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Clostridioides difficile (formerly Clostridium) is a major cause of healthcare associated diarrhea, and is increasingly present in the community. Historically, C difficile infection was considered easy to diagnose and treat. Over the past two decades, however, diagnostic techniques have changed in line with a greater understanding of the physiopathology of C difficile infection and the use of new therapeutic molecules. The evolution of diagnosis showed there was an important under- and misdiagnosis of C difficile infection, emphasizing the importance of algorithms recommended by European and North American infectious diseases societies to obtain a reliable diagnosis. Previously, metronidazole was considered the reference drug to treat C difficile infection, but more recently vancomycin and other newer drugs are shown to have higher cure rates. Recurrence of infection represents a key parameter in the evaluation of new drugs, and the challenge is to target the right population with the adapted therapeutic molecule. In multiple recurrences, fecal microbiota transplantation is recommended. New approaches, including antibodies, vaccines, and new molecules are already available or in the pipeline, but more data are needed to support the inclusion of these in practice guidelines. This review aims to provide a baseline for clinicians to understand and stratify their choice in the diagnosis and treatment of C difficile infection based on the most recent data available.

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“…84 Recently published retrospective studies have shown conflicting results regarding the efficacy of tigecycline for fulminant CDI. 85,86,87,88 Because of the poor outcomes associated with fulminant CDI, there may be a role for adjunctive tigecycline. 84 Consideration of surgical intervention and faecal microbiota transplantation (FMT) in such settings is also indicated.…”

Section: What Are the Recommended Treatment Options For An Initial Episode Of Fulminant Clostridioides Difficile Infection?mentioning

confidence: 99%

South African Society of Clinical Microbiology Clostridioides difficile infection diagnosis, management and infection prevention and control guideline

Nana

Moore²,

Boyles

et al. 2020

Southern African Journal of Infectious Diseases

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Clostridioides difficile infection (CDI) is a problem in both developed and developing countries and is a common hospital-acquired infection. This guideline provides evidence-based practical recommendations for South Africa and other developing countries. The scope of the guideline includes CDI diagnostic approaches; adult, paediatric and special populations treatment options; and surveillance and infection prevention and control recommendations.

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The role of tigecycline in the management of Clostridium difficile infection: a retrospective cohort study

Abstract: Adding tigecycline to CDI standard therapy did not increase the clinical cure nor reduce the rate of CDI recurrences.

Cited by 19 publications

References 16 publications

Novel Antimicrobials for the Treatment of Clostridium difficile Infection

Novel Antimicrobials for the Treatment of Clostridium difficile Infection

Clostridioides difficile: diagnosis and treatments

South African Society of Clinical Microbiology Clostridioides difficile infection diagnosis, management and infection prevention and control guideline

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