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Use of tigecycline in pediatric clinical practice
Maria Vincenza Mastrolia1, Luisa Galli1, Maurizio De Martino1
1a Pediatric Infectious Disease Unit , Anna Meyer Children's University Hospital , Florence , Italy.
Insights
Tigecycline shows promise for treating severe pediatric infections, with a 74.2% success rate in reviewed cases. This antimicrobial agent is generally well-tolerated in children, though more research is needed.
Area of Science:
- Pharmacology
- Pediatric Infectious Diseases
Background:
- Tigecycline, a minocycline derivative, is an extended-spectrum antimicrobial.
- Its use in pediatric populations is limited to challenging infections.
Purpose of the Study:
- To review clinical efficacy and tolerability of tigecycline in infants and children.
- To summarize existing evidence on tigecycline use in pediatric patients.
Main Methods:
- Literature search of Cochrane Library, EMBASE, and MEDLINE databases up to January 5, 2017.
- Included search terms: tigecycline, newborn, infant, child, pediatrics, adolescent, human, clinical trial, case report.
- Included 1 pharmacokinetic study and 16 case reports.
Main Results:
- Seventeen publications were analyzed, involving patients with a mean age of 4.45 years.
- Favorable clinical response was observed in 74.2% of pediatric cases.
- Tigecycline was well-tolerated and effective in nonbacteremic patients.
Conclusions:
- Tigecycline is a potential option for life-threatening pediatric infections.
- Good clinical response and tolerability were noted, particularly in nonbacteremic patients.
- Limited clinical data necessitates further research and studies.
Introduction:
Tigecycline, a derivative of minocycline, is an extended-spectrum antimicrobial agent. It has a restricted approval field in children and the experience of its adoption in clinical practice is reserved for cases of challenging infections. The aim of this review was to summarize evidence regarding the use of tigecycline in infants and children, focusing on the drug's clinical efficacy data and tolerability profile. Areas covered: We have conducted a literature search of the Cochrane Library, EMBASE, and MEDLINE databases, from their inception through 5 January 2017, using the following terms: tigecycline, newborn, infant, child, pediatrics, adolescent, human, clinical trial, and case report. Articles were excluded if they were redundant or not pertinent. Bibliographies of all relevant articles were also evaluated. Seventeen publications were included: 1 pharmacokinetic study, 16 case reports. In the selected publications, the patients' mean age was 4.45 years, 38.7% of children was <3 years old and favorable clinical response was achieved in 74.2% of cases. Expert commentary: Tigecycline may be a considerable option in life-threatening infections in pediatric patients. Its administration is well tolerated and has demonstrated a good clinical response in nonbacteremic patients. However, the available clinical records are limited and more studies are needed.