Tigecycline: a first in class glycylcycline

Abstract

Tigecycline is a glycylcycline antibiotic that was developed by Wyeth in response to the worldwide threat of emerging resistance to antibiotics. Glycylcyclines are a unique chemical class of antibiotics that act to inhibit protein synthesis at the level of the bacterial ribosome. Tigecycline has shown a broad spectrum of antibacterial activity, including inhibition of gram-positive, gram-negative, atypical, and anaerobic bacteria. It is active against multiply resistant gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), penicillin-resistant Streptococcus pneumoniae (PRSP), vancomycin-resistant Enterococcus spp. (VRE), and extended-spectrum β-lactamase (ESBL), producing Escherichia coli and Klebsiella pneumoniae. In addition, tigecycline is active against strains that carry any of the two major types of tetracycline resistance genes for ribosomal protection and efflux-mediated resistance. In clinical trials, tigecycline appears to be generally well tolerated, safe, and effective in treating skin and soft tissue, as well as complicated intra-abdominal infections. Additional studies, which will further confirm the clinical utility of tigecycline in the management of serious infections, are ongoing.