Related Experiment Video

Updated: Apr 28, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

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High dose tigecycline in critically ill patients with severe infections due to multidrug-resistant bacteria

Gennaro De Pascale, Luca Montini, Mariano Pennisi

    Critical Care (London, England)
    |June 3, 2014
    PubMed
    Abstract

    Insights

    Higher tigecycline doses (TGC) show good safety and efficacy in critically ill patients with multidrug-resistant (MDR) infections. High-dose TGC improved outcomes in ventilation-associated pneumonia, suggesting a potential treatment strategy.

    Area of Science:

    • Critical Care Medicine
    • Infectious Diseases
    • Pharmacology

    Background:

    • Rising incidence of multidrug-resistant (MDR) bacteria in ICUs necessitates effective treatments.
    • Tigecycline (TGC) is increasingly used for severe infections, but concerns about its efficacy exist.
    • Higher dosages of TGC have been proposed to address these concerns.

    Purpose of the Study:

    • To investigate the safety and efficacy of tigecycline (TGC) at doses higher than standard.
    • To evaluate the outcomes of high-dose TGC in critically ill patients with severe infections.

    Main Methods:

    • Retrospective study of prospectively collected data from ICU patients treated with TGC.
    • Analysis of safety profile and efficacy of standard-dose (SD) versus high-dose (HD) TGC regimens.
    • Subgroup analysis in patients with ventilation-associated pneumonia (VAP).

    Main Results:

    • No adverse events led to TGC discontinuation or dose reduction in either SD or HD groups.
    • In the VAP subgroup, high-dose TGC was an independent predictor of clinical cure (OR 6.25).
    • Initial inadequate antimicrobial treatment and higher SOFA scores were associated with clinical failure in VAP patients.

    Conclusions:

    • Tigecycline (TGC) is well-tolerated at higher than standard doses in critically ill patients.
    • High-dose TGC demonstrated improved clinical outcomes in the ventilation-associated pneumonia subgroup, particularly for Gram-negative MDR bacteria.

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