Tigecycline therapy for infections due to carbapenemase-producing Klebsiella pneumoniae in critically ill patients

Moreno, Bárbara Balandín; Simón, I. Fernández; García, V. Pintado; Romero, Isabel Sánchez; Fernandez, Benoît; Ortega, Marcos; Carmona, Sara Alcántara; Redondo, Marina Pérez; Anuncibay, Pedro Galdos

doi:10.3109/00365548.2013.861608

Cited by 37 publications

(22 citation statements)

References 30 publications

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“…In a recent randomized phase 2 trial, high dose TGC (100 mg q12h) was associated with better clinical efficacy than imipenem for treating nosocomial pneumonia caused by gram‐positive and gram‐negative bacteria in adult patients . Another retrospective study involving 15 patients receiving different doses of TGC for severe carbapenem‐resistant K pneumoniae infections reported that the overall 30‐day mortality rate was 33.3% for daily dose of 100 mg and 20% for daily dose of 200 mg . De Pascale et al reported that high dose TGC was not associated with additional toxicity in the treatment of serious infections in critically ill patients .…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of tigecycline in the treatment of infections caused by carbapenem‐resistant gram‐negative bacteria in pediatric liver transplant recipients: A retrospective study

Chen

Shen

Pang

et al. 2019

Transplant Infectious Dis

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Introduction Tigecycline (TGC) is effective for the infections caused by carbapenem‐resistant gram‐negative bacteria (CRGNB) in adults, but it is not investigated systematically in children because of concern about adverse effects. This study aimed to analyze the effectiveness of TGC in treating CRGNB infections in children after receiving liver transplant. Methods The subjects in this retrospective study were pediatric liver transplant recipients treated with TGC for at least 3 days to fight microbiologically verified CRGNB infection after initial antibiotic failure during the period from January 2014 to May 2018. Clinical and microbiological outcomes were reviewed to evaluate the efficacy and safety of TGC. Results Of the 1177 pediatric liver transplant recipients, 13 patients were eligible for inclusion in this analysis. All the patients received TGC at dose of 2 mg/kg every 12 hours for a duration of 10.1 ± 5.1 days on average to treat CRGNB infections, including complicated intra‐abdominal infection, ventilator‐associated pneumonia, and bloodstream infection. The isolates included Klebsiella pneumoniae (69.2%, 9/13) and Acinetobacter baumannii (30.8%, 4/13). Clinical efficacy was achieved in 84.6% (11/13) and pathogen eradicated in 69.2% (9/13) of the patients. The overall mortality rate was 15.4% (2/13). No TGC‐related serious adverse event was reported. Conclusion Tigecycline can be considered in combination antimicrobial regimen for treating CRGNB‐related infections in pediatric liver transplant recipients.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of tigecycline in the treatment of infections caused by carbapenem‐resistant gram‐negative bacteria in pediatric liver transplant recipients: A retrospective study

Chen

Shen

Pang

et al. 2019

Transplant Infectious Dis

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“…Two studies have reported its use in combination with other antimicrobials in infections caused by carbapenemase-producing K. pneumoniae [11,12]. The use of HD tigecycline did not influence the outcome in a small series of critically ill patients with infections due to carbapenemase-producing K. pneumoniae [13]. In the study by De Pascale and colleagues [1], as in previous studies [10-13], this HD was not associated with undesirable effects.…”

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confidence: 99%

High dose of tigecycline for extremely resistant Gram-negative pneumonia: yes, we can

Garnacho‐Montero

Ferrándiz-Millón

2014

Crit Care

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Few antimicrobials are currently active to treat infections caused by extremely resistant Gram-negative bacilli (ERGNB), which represent a serious global public health concern. Tigecycline, which covers the majority of these ERGNB (with the exception of Pseudomonas aeruginosa), is not currently approved for hospital-acquired pneumonia, and several meta-analyses have suggested an increased risk of death in patients receiving this antibiotic. Other studies suggest that the use of high-dose tigecycline may represent an alternative in daily practice. De Pascale and colleagues report that the clinical cure rate in patients with ventilator-associated pneumonia is significantly higher with a high dose of tigecycline than with the conventional dose, although mortality was unaffected. This high dose is safe; no patients required discontinuation or dose reduction.

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“…These effects were independent of the infection type, trial design, and study size [7]. However, TGC has been prescribed in life-threatening infections for which there were few or no alternative agents [9–11, 15, 24]. A high-dose TGC regimen has been shown to result in better outcomes in patients with severe infections caused by MDR bacteria [15].…”

Section: Discussionmentioning

confidence: 99%

Tigecycline Therapy for Nosocomial Pneumonia due to Carbapenem-Resistant Gram-Negative Bacteria in Critically Ill Patients Who Received Inappropriate Initial Antibiotic Treatment: A Retrospective Case Study

Zhu

Chen

et al. 2016

BioMed Research International

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Background. Nosocomial pneumonia due to carbapenem-resistant Gram-negative bacteria (CRGNB) is a growing concern because treatment options are limited and the mortality rate is high. The effect of tigecycline (TGC) on nosocomial pneumonia due to CRGNB in patients who have received inappropriate initial empiric antibiotic treatment (IIAT) is unclear. Therefore, this study aimed to examine the effect of TGC on nosocomial pneumonia due to CRGNB in critically ill patients who had received IIAT. Methods. A retrospective study was conducted in an adult respiratory intensive care unit. Data were obtained and analyzed for all patients who were treated with TGC ≥ 3 days for microbiologically confirmed nosocomial pneumonia due to CRGNB and had experienced initial antibiotic failure. Clinical and microbiological outcomes were investigated. Results. Thirty-one patients with hospital-acquired pneumonia or ventilator-associated pneumonia were included in the study. The majority of the responsible organisms were carbapenem-resistant Acinetobacter baumannii (67.7%), followed by Klebsiella pneumoniae (16.1%) and Escherichia coli (9.7%). Twenty patients were treated with high-dose TGC therapy (100 mg every 12 h after a 200 mg loading dose), and the others received a standard-dose therapy (50 mg every 12 h after a 100 mg loading dose). The duration of TGC therapy was 14.3 ± 2.8 days. The global clinical cure rate and the microbiological eradication rate were 48.4% and 61.3%, respectively. The overall ICU mortality rate was 45.2%. A higher score on the Acute Physiology and Chronic Health Evaluation II and a longer duration of IIAT were associated with clinical failure. High-dose TGC therapy had a higher clinical success rate [65.0% (13/20) versus 18.2% (2/11), P = 0.023] and a lower ICU mortality rate [30.0% (6/20) versus 72.7% (8/11), P = 0.031] than the standard-dose therapy. Conclusions. TGC, especially a high-dose regimen, might be a justifiable option for critically ill patients with nosocomial pneumonia due to CRGNB who have received IIAT when the options for these patients are limited.

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Tigecycline therapy for infections due to carbapenemase-producing Klebsiella pneumoniae in critically ill patients

Cited by 37 publications

References 30 publications

Effectiveness of tigecycline in the treatment of infections caused by carbapenem‐resistant gram‐negative bacteria in pediatric liver transplant recipients: A retrospective study

Effectiveness of tigecycline in the treatment of infections caused by carbapenem‐resistant gram‐negative bacteria in pediatric liver transplant recipients: A retrospective study

High dose of tigecycline for extremely resistant Gram-negative pneumonia: yes, we can

Tigecycline Therapy for Nosocomial Pneumonia due to Carbapenem-Resistant Gram-Negative Bacteria in Critically Ill Patients Who Received Inappropriate Initial Antibiotic Treatment: A Retrospective Case Study

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