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Tigecycline: a critical analysis.

Gary E Stein1, William A Craig

  • 1Department of Medicine, Michigan State University, East Lansing, Michigan 48824, USA. steing@msu.edu

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|July 14, 2006
PubMed
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Tigecycline is a novel glycylcycline antibiotic effective against resistant bacteria like MRSA and VRE. It offers parenteral treatment for complex infections with minimal drug interactions and manageable side effects.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Microbiology

Background:

  • Tigecycline represents a new class of antibiotics, the glycylcyclines.
  • It addresses key tetracycline resistance mechanisms: efflux pumps and ribosomal protection.
  • Approved by the FDA, it combats a broad spectrum of pathogens.

Purpose of the Study:

  • To review the characteristics and clinical utility of tigecycline.
  • To highlight its activity against challenging multidrug-resistant organisms.
  • To discuss its pharmacokinetic profile and adverse effects.

Main Methods:

  • Review of preclinical and clinical data on tigecycline.
  • Analysis of tigecycline's in vitro activity against various bacterial strains.
  • Evaluation of its pharmacokinetic and safety profile.

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Main Results:

  • Tigecycline demonstrates broad-spectrum activity, including against Gram-positive, Gram-negative, anaerobic, and atypical pathogens.
  • Effective against resistant strains such as MRSA, VRE, and ESBL-producing Enterobacteriaceae.
  • Minimal impact of renal impairment on clearance; no significant CYP450 interactions.
  • Primary adverse effects include nausea and vomiting; suitable for parenteral administration.

Conclusions:

  • Tigecycline is a valuable option for complicated skin/skin-structure and intra-abdominal infections.
  • Its broad spectrum and activity against resistant pathogens make it ideal for empirical therapy.
  • Especially useful in polymicrobial infections requiring deep tissue penetration or when multidrug-resistant organisms are suspected.