Tigecycline: a critical update

Area of Science:

• Pharmacology
• Infectious Diseases
• Bacteriology

Background:

• Tigecycline is the first FDA-approved glycylcycline antibiotic.
• It exhibits broad in vitro activity against Gram-positive, Gram-negative, and anaerobic bacteria, including multidrug-resistant (MDR) strains.
• Minimal activity is observed against Pseudomonas aeruginosa and Proteus spp., with limited reported resistance to tigecycline.

Purpose of the Study:

• To review the efficacy and safety of tigecycline.
• To evaluate its role as an alternative to existing antibiotics facing increasing resistance.
• To highlight its potential in treating complicated infections.

Main Methods:

• Review of clinical trial data for complicated skin and skin-structure infections (cSSSIs).
• Evaluation of clinical trial data for complicated intra-abdominal infections (cIAIs).
• Assessment of adverse events and comparison with standard therapies.

Main Results:

• Tigecycline demonstrated equivalent efficacy and safety to vancomycin/aztreonam for cSSSIs.
• Tigecycline was as effective as imipenem/cilastatin for cIAIs.
• Adverse events, primarily nausea and vomiting, were tolerable.

Conclusions:

• Tigecycline is a viable monotherapy alternative to older broad-spectrum antibiotics.
• Its role is significant given the increasing global resistance to established agents.
• Further data suggest its importance in managing infections caused by MDR pathogens.