Tigecycline use in serious nosocomial infections: a drug use evaluation

Prospective observational study of tigecycline use was conducted in a 1500 beds university hospital. From January 1, 2007 and January 31, 2010, 207 pts were treated with tigecycline for the following indications: intra-abdominal, pneumonia, bloodstream and complicated skin and soft tissue infections and febrile neutropenia. The therapy was targeted in 130/207 (63%) and empirical in 77/207 (37%) patients. All bacteria treated were susceptible to tigecycline. Median duration of tigecycline therapy was 13 days (range, 6-28). Clinical success was obtained in 151/207 (73%) cases, with the highest success rate recorded in intra-abdominal infections [81/99 (82%)]. Microbiological success was achieved in 100/129 (78%) treated patients. Adverse clinical events were seen in 16/207 patients (7.7%):Considering the lack of data on tigecycline for critically ill patients, we think that the reported data of our clinical experience despite some limitations can be useful for clinicians.The management of hospital-acquired bacterial infections is becoming a significant challenge for health care providers because of the increased prevalence of multidrug-resistant (MDR) bacteria like methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus spp. (VRE), Acinetobacter baumannii, Klebsiella pneumoniae, carbapenemase -producing Enterobacteriaceae, and extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae. Increased morbidity and mortality, duration of hospitalization, and medical care costs are all associated with MDR organisms [1]. Delay of appropriate empiric antimicrobial therapy is known to increase morbidity and mortality among affected patients and inadequate therapy has been found to be associated with excess mortality and increased duration of hospitalization [2]. There is a high rate of resistance to commonly used antimicrobial agents, including beta-lactams (penicillins and cephalosporins), fluoroquinolones, aminoglycosides and glycopepti