Tigecycline

What is Tigecycline

Tigecycline is an intravenous glycylcycline antibiotic for the treatment of complicated skin and skin structure infections and complicated intra-abdominal infections.

It is a derivative of minocycline and was developed to circumvent resistance mechanisms.

The spectrum of activity of tigecycline is similar to that of tetracycline, doxycycline, and minocycline; however, tigecycline shows activity against tetracycline-resistant organisms.

Tigecycline has activity against methicillin-resistant Staphylococcus aureus (MRSA) and S. epidermidis (MRSE), penicillin-resistant Streptococcus pneumoniae (PRSP), and vancomycin-resistant enterococci (VRE). There have been no reports of cross-resistance between tigecycline and other antibiotics.

Tigecycline has also shown activity against multi-drug resistant organisms. Tigecycline and other glycylcycline antibiotics are associated with adverse reactions and drug interactions similar to the tetracyclines.

Tigecycline failed to demonstrate efficacy in patients with hospital acquired pneumonia, and a sub-group of patients with ventilator-associated pneumonia (VAP) had lower cure rates and higher mortality than the comparator group.

The FDA approved tigecycline in June 2005 for complicated intra-abdominal infections and complicated skin and skin structure infections due to gram-negative and gram-positive organisms, anaerobes, and both MSSA and MRSA.

In March 2009, the FDA approved tigecycline for community-acquired pneumonia (CAP).

Brand Name

Tygacil

Indications

  1. Acinetobacter baumannii
  2. Aeromonas hydrophila
  3. Bacteroides fragilis
  4. Bacteroides ovatus
  5. Bacteroides thetaiotaomicron
  6. Bacteroides uniformis
  7. Bacteroides vulgatus
  8. Citrobacter freundii
  9. Citrobacter koseri
  10. Clostridium perfringens
  11. community-acquired pneumonia
  12. Enterobacter cloacae
  13. Enterococcus avium
  14. Enterococcus casseliflavus
  15. Enterococcus faecalis
  16. Enterococcus faecium
  17. Enterococcus gallinarum
  18. Escherichia coli
  19. febrile neutropenia
  20. Haemophilus influenzae (beta-lactamase negative)
  21. Haemophilus influenzae (beta-lactamase positive)
  22. Haemophilus parainfluenzae
  23. intraabdominal infections
  24. Klebsiella aerogenes
  25. Klebsiella oxytoca
  26. Klebsiella pneumoniae
  27. Legionella pneumophila
  28. Listeria monocytogenes
  29. Mycobacterium abscessus
  30. Mycobacterium fortuitum
  31. Parabacteroides distasonis
  32. Pasteurella multocida
  33. Peptostreptococcus micros
  34. Peptostreptococcus sp.
  35. Porphyromonas sp.
  36. Prevotella sp.
  37. Serratia marcescens
  38. skin and skin structure infections
  39. Staphylococcus aureus (MRSA)
  40. Staphylococcus aureus (MSSA)
  41. Staphylococcus epidermidis
  42. Staphylococcus haemolyticus
  43. Stenotrophomonas maltophilia
  44. Streptococcus agalactiae (group B streptococci)
  45. Streptococcus anginosus
  46. Streptococcus constellatus
  47. Streptococcus intermedius
  48. Streptococcus pneumoniae
  49. Streptococcus pyogenes (group A beta-hemolytic streptococci)

Side Effects

  1. abdominal pain
  2. anaphylactic shock
  3. anaphylactoid reactions
  4. anemia
  5. anorexia
  6. asthenia
  7. azotemia
  8. candidiasis
  9. chills
  10. cholestasis
  11. diarrhea
  12. dizziness
  13. dysgeusia
  14. dyspepsia
  15. edema
  16. elevated hepatic enzymes
  17. enamel hypoplasia
  18. eosinophilia
  19. growth inhibition
  20. headache
  21. hepatic failure
  22. hyperamylasemia
  23. hyperbilirubinemia
  24. hypocalcemia
  25. hypoglycemia
  26. hyponatremia
  27. hypophosphatemia
  28. impaired wound healing
  29. infection
  30. injection site reaction
  31. jaundice
  32. leukorrhea
  33. metabolic acidosis
  34. nausea
  35. pancreatitis
  36. phlebitis
  37. photosensitivity
  38. prolonged bleeding time
  39. pruritus
  40. pseudomembranous colitis
  41. pseudotumor cerebri
  42. rash
  43. Stevens-Johnson syndrome
  44. superinfection
  45. thrombocytopenia
  46. tooth discoloration
  47. vaginitis
  48. vomiting

Monitoring Parameters

  • CBC with differential
  • LFTs
  • serum amylase
  • serum bilirubin

Contraindications

  • breast-feeding
  • children
  • colitis
  • diabetes mellitus
  • diarrhea
  • geriatric
  • GI disease
  • GI perforation
  • hepatic disease
  • infants
  • inflammatory bowel disease
  • laboratory test interference
  • mortality
  • neonates
  • pancreatitis
  • pregnancy
  • pseudomembranous colitis
  • respiratory infection
  • tetracyclines hypersensitivity
  • ulcerative colitis

Interactions

  • Dichlorphenamide
  • Estradiol
  • Estradiol Cypionate; Medroxyprogesterone
  • Oral Contraceptives
  • Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
  • Warfarin
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