Tigecycline is efficacious in the treatment of complicated intra-abdominal infections

Abstract

TGC is efficacious in the treatment of patients with cIAIs and TGC met per the protocol-specified statistical criteria for noninferiority to the comparator, IMI/CIS.

The role of tigecycline in the treatment of infections in light of the new black box warning

“…However, in reviewing the studies of tigecycline for FDA-approved indications, the agent demonstrated similar results when evaluated against its bactericidal comparators [6][7][8]. Further assessment of tigecycline in VAP studies postulated that the mortality risk may actually be attributed to suboptimal dosing of the agent [9].…”

Diagnosis and antimicrobial treatment of invasive infections due to multidrug-resistant Enterobacteriaceae. Guidelines of the Spanish Society of Infectious Diseases and Clinical Microbiology

“…224 In one study of cIAI, the cure rate in the subgroup of patients with documented E. coli infection treated with tigecycline was 10% lower than that observed in the imipenem arm (88% vs 98%), in line with the lower clinical cure rate observed in the subgroup with complicated appendicitis (87% vs 100%). 229 This difference was not found in other studies in patients with cIAI. Regarding the severity of the infections, most were moderate, and immunocompromised patients were excluded.…”

“…Regarding the severity of the infections, most were moderate, and immunocompromised patients were excluded. [221][222][223][224][225][226][227][228][229][230][231] Therefore, from the evidence provided by these studies it cannot be inferred that the efficacy of tigecycline in monotherapy would be the same in more severe infections.…”

“…[221][222][223][224][225][226][227][228][229][230][231] The tigecycline dose used was 100 mg loading-dose followed by 50 mg/12 h. From the published clinical trials, information can be obtained about the clinical response in Enterobacteriaceae infections. Overall, 92% of potentially susceptible Enterobacteriaceae (excluding Proteeae tribe) were E. coli and Klebsiella spp.…”

“…226 Fifteen patients from 2 double-blind trials on cIAI had an infection caused by an ESBL-producer, and 12 (80%) showed a favourable clinical response. 228,229 As regards the potential utility of tigecycline in the treatment of infections caused by CPE, available clinical data come from observational studies and case series in which patients were usually treated in combinations, in which some of them received tigecycline; most reported infections were caused by KPC-, VIM-or OXA-48-producing K. pneumoniae. 133,138,139,164,211,[248][249][250][251][252][253][254] Overall, crude mortality among patients treated with tigecycline in monotherapy tended to be higher than in those treated with tigecycline in combination (range of mortality in studies in which data for this comparison was provided, 40-80% vs 0-33% [133][134][135]138,139,251,252 ), but these data are not controlled for confounders.…”