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
- Acinetobacter baumannii
- Aeromonas hydrophila
- Bacteroides fragilis
- Bacteroides ovatus
- Bacteroides thetaiotaomicron
- Bacteroides uniformis
- Bacteroides vulgatus
- Citrobacter freundii
- Citrobacter koseri
- Clostridium perfringens
- community-acquired pneumonia
- Enterobacter cloacae
- Enterococcus avium
- Enterococcus casseliflavus
- Enterococcus faecalis
- Enterococcus faecium
- Enterococcus gallinarum
- Escherichia coli
- febrile neutropenia
- Haemophilus influenzae (beta-lactamase negative)
- Haemophilus influenzae (beta-lactamase positive)
- Haemophilus parainfluenzae
- intraabdominal infections
- Klebsiella aerogenes
- Klebsiella oxytoca
- Klebsiella pneumoniae
- Legionella pneumophila
- Listeria monocytogenes
- Mycobacterium abscessus
- Mycobacterium fortuitum
- Parabacteroides distasonis
- Pasteurella multocida
- Peptostreptococcus micros
- Peptostreptococcus sp.
- Porphyromonas sp.
- Prevotella sp.
- Serratia marcescens
- skin and skin structure infections
- Staphylococcus aureus (MRSA)
- Staphylococcus aureus (MSSA)
- Staphylococcus epidermidis
- Staphylococcus haemolyticus
- Stenotrophomonas maltophilia
- Streptococcus agalactiae (group B streptococci)
- Streptococcus anginosus
- Streptococcus constellatus
- Streptococcus intermedius
- Streptococcus pneumoniae
- Streptococcus pyogenes (group A beta-hemolytic streptococci)
Side Effects
- abdominal pain
- anaphylactic shock
- anaphylactoid reactions
- anemia
- anorexia
- asthenia
- azotemia
- candidiasis
- chills
- cholestasis
- diarrhea
- dizziness
- dysgeusia
- dyspepsia
- edema
- elevated hepatic enzymes
- enamel hypoplasia
- eosinophilia
- growth inhibition
- headache
- hepatic failure
- hyperamylasemia
- hyperbilirubinemia
- hypocalcemia
- hypoglycemia
- hyponatremia
- hypophosphatemia
- impaired wound healing
- infection
- injection site reaction
- jaundice
- leukorrhea
- metabolic acidosis
- nausea
- pancreatitis
- phlebitis
- photosensitivity
- prolonged bleeding time
- pruritus
- pseudomembranous colitis
- pseudotumor cerebri
- rash
- Stevens-Johnson syndrome
- superinfection
- thrombocytopenia
- tooth discoloration
- vaginitis
- 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
