Abstract
OBJECTIVES: To describe real-world use of tigecycline in cIAIs patients. METHODS: A retrospective, observational study enrolled cIAIs patients hospitalized in The First Affiliated Hospital, Sun Yat-sen University from January 1, 2013 to June 30, 2017 was conducted. Patients’ data were collected and matched based on age, gender, and Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II) score according to receiving first-line, later-line, or no tigecycline during hospitalization. RESULTS: Data were collected for 52 patients. 82.6% were male. Mean age was 57.8 years and APACHE II score was 14.8. The incidence of both extended-spectrum beta-lactamase producing and carbapenem-resistant pathogens was high on initial culture; however, few patients received first-line tigecycline. No significant difference in mortality rate was identified among first-line, later-line and no tigecycline users. Of surviving patients, shorter hospital length of stay was observed for patients receiving first- vs later-line or no tigecycline, respectively. ICU length-of-stay was shorter in patients receiving first- vs later-line or no tigecycline. CONCLUSIONS: First-line tigecycline use was rare in our surgical intensive care unit. Resistant organisms were commonly cultured from initial specimens. Although these results are limited by small patient numbers and single center, our results suggest that early tigecycline use may have significant benefits with similar mortality. Further research is warranted to demonstrate the values of early tigecycline use in cIAIs patients.
Highlights
Intra-abdominal infections have a high incidence and are often associated with poor prognosis [1]
No significant difference in mortality rate was identified among first-line, later-line and no tigecycline users
Resistant organisms were commonly cultured from initial specimens. These results are limited by small patient numbers and single center, our results suggest that early tigecycline use may have significant benefits with similar mortality
Summary
Intra-abdominal infections have a high incidence and are often associated with poor prognosis [1]. Complex intra-abdominal infections (cIAIs) refer to bacteria passing through defects in the digestive tract and invading the peritoneal cavity, leading to abscess formation or peritonitis. The clinical treatment of complex intra-abdominal infections is complicated, and patients admitted to the ICU are generally difficult to solve by a single treatment. The treatment includes drainage of effusion or control of infection under surgical and interventional guidance, supplemented by broad-spectrum antibiotics. Appropriate empirical antimicrobial therapy can increase the success rate of clinical treatment, reduce the length of hospital stay and hospitalization costs, and minimize antimicrobial resistance caused by selective pressure. Inappropriate treatment can lead to treatment failure, prolong hospital stay, and increase mortality
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