Efficacy of tigecycline in treating severe infections of patients with hematological diseases

Abstract

To evaluate the efficacy and safety of tigecycline in treating secondary infections of patients with hematological diseases. A total of 85 cases of hematological patients with secondary infections were classified into empirical and targeted therapy groups. Empirical therapy group was composed of patients receiving tigecycline as an alternative due to ineffective anti-infection treatment for 3-5 days in the absence of microbiological evidence while those taking tigecycline based on microbiological evidence belonged to targeted therapy group. Dosage regimen of tigecycline: loading dose 100 mg, 50 mg every 12 hours as maintenance therapy for 2-4 weeks. Among them, except for 11 cases of bloodstream infections and 2 cases of fever for unknown reasons, the most common site for infection was lower respiratory tract. Among 45 isolated bacterial strains, Stenotrophomonas maltophilia (40%) was the most commonly seen while extended spectrum beta-lactamases (ESBLS)+ multidrug resistant gram negative bacilli 15.6%. Among 5 bacterial strains, there were 3 methicillin-resistant Staphylococcus aureus+golden staphylococci strains and 2 excrement enterococci. The total effective rate of tigecycline was 72.9%. And the bacterial clearance rates of acinetobacter baumannii, ESBLS+ gram-negative bacillus and stenotrophomonas maltophilia were 85%, 70% and 55% respectively. The effect of tigecycline was equivalent for two groups. Pneumonia patients obtained an effective rate of 71%, compared to those with bloodstream infections (54.5%). For patients whose absolute neutrophil counts were less than 0.2 × 10⁹/L, the effective rate decreased obviously (45% vs 81.5%, P = 0.003). Adverse reaction was mild due to mostly gastrointestinal symptoms. Tigecycline is a new treatment choice in treating secondary multidrug resistant infections of patients with hematological diseases. Empirical therapy of tigecycline may improve the therapeutic efficacy of patients non-responding favorably to conventional anti-infectives.