Abstract
Background: With the rapid growing of multi-drug resistant organisms (MDROs) and a lack of newly developed antimicrobial agent, tigecycline has been given high hopes and expectations as a candidate to treat all these MDROs except Pseudomonas aeruginosa, Proteus mirabilis. Methods: All hospitalized adult subjects who received treatment with tigecycline were enrolled at a medical center in Northern Taiwan. Patients treated with tigecycline for 48 hours were excluded. Results: Almost half patients were shown to have successful clinical response to tigecycline (151/309; 49%), with high clinical success observed in complicated skin and skin structure infections (101/137; 74%). Treatment failure was mostly seen in hospital-acquired pneumonias with MDROs isolates (83/100; 83%). The mortality rate was 27% (84/309), which was mainly due to hospital acquired pneumonias (48/101; 48%). Conclusion: Our study show good efficacy of tigecycline in the treatment of complicated skin and skin structure infections. Regarding to the treatment of pneumonia, ineffective response was seen as most patients with HAP in our study. Its use in treating other infections not yet approved by the current guidelines requires further research to obtain enough evidence for future approval.
Highlights
Materials & MethodThe substantially increasing prevalence of multi-drug resistant organisms (MDROs) especially the extended-spectrum B-lactamase (ESBL) producing Eenterobacteriaceae isolates and carbapenem resistant Acinetobacter baumanni and pseudomonas aeruginosa were found in Taiwan and in the other areas of word [1,2,3]
Regarding to the treatment of pneumonia, ineffective response was seen as most patients with hospital acquired pneumonia (HAP) in our study
Tigecycline, a derivative of minocycline, is one of the glycylcycline classes of antibiotics. It has a broad spectrum of activity against a variety of Gram-positive and Gram-negative aerobic MDROs, anaerobic and atypical pathogens, including vancomycin-resistant enterococci, methicillin-resistant Staphylococcus aureus, penicillinresistant Streptococcus pneumoniae, Enterobacteriaceae, nonEnterobacteriaceae except Pseudomonas, Chlamydia pneumoniae, Mycoplasma pneumoniae, and Rapid growing Mycobacteria
Summary
Materials & MethodThe substantially increasing prevalence of multi-drug resistant organisms (MDROs) especially the extended-spectrum B-lactamase (ESBL) producing Eenterobacteriaceae isolates and carbapenem resistant Acinetobacter baumanni and pseudomonas aeruginosa were found in Taiwan and in the other areas of word [1,2,3]. Clinicians face tremendous challenges in the treatment of those patients, especially in the healthcare-associated infections (HAI). They result in greater mortality and morbidity, but can increase the length and cost of hospital stay. Inadequate or delayed use of empiric antimicrobial therapy is known to be associated with higher mortality, longer duration of hospitalization, and increased prevalence of MDROs [1]. Tigecycline, a derivative of minocycline, is one of the glycylcycline classes of antibiotics It has a broad spectrum of activity against a variety of Gram-positive and Gram-negative aerobic MDROs, anaerobic and atypical pathogens, including vancomycin-resistant enterococci, methicillin-resistant Staphylococcus aureus, penicillinresistant Streptococcus pneumoniae, Enterobacteriaceae, nonEnterobacteriaceae except Pseudomonas, Chlamydia pneumoniae, Mycoplasma pneumoniae, and Rapid growing Mycobacteria. Due to the growing number of MDROs with a lack of newly developed antimicrobial agent, tigecycline has been given high hopes and expectations as a candidate drug to treat infection with MDROs
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