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Tigecycline therapy for multidrug-resistant bacteria: is it the right choice for pediatric patients
Gulhadiye Avcu1, Sema Yildirim Arslan1, Asli Arslan1
1Ege University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Infectious Diseases, Izmir, Turkey.
Insights
Tigecycline showed high clinical and microbiological response rates in hospitalized children, particularly in combination therapy. However, outcomes varied by infection site and pathogen, with no major adverse events observed.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Pharmacology
Background:
- Rising global incidence of multidrug-resistant (MDR) infections necessitates effective therapeutic options.
- Tigecycline offers broad-spectrum antibacterial activity, making it a valuable agent against MDR pathogens.
- Assessing tigecycline's efficacy and safety in pediatric populations is crucial for guiding clinical practice.
Purpose of the Study:
- To evaluate the clinical, microbiological, and laboratory outcomes of tigecycline treatment in hospitalized pediatric patients.
- To determine the efficacy and safety profile of tigecycline in treating various infections in children.
- To identify factors influencing treatment response, such as infection site and causative microorganisms.
Main Methods:
- Retrospective analysis of medical records of pediatric patients treated with tigecycline from April 2018 to April 2023.
- Inclusion of 67 patients with diverse underlying conditions and infections.
- Evaluation of demographic, clinical, and laboratory data to assess treatment outcomes.
Main Results:
- The most common infections treated were lower respiratory tract, intra-abdominal, and bloodstream infections.
- Acinetobacter spp., Klebsiella spp., and Enterococcus spp. were the most frequently isolated pathogens.
- Tigecycline achieved a clinical response in 65.6% and microbiological response in 62.6% of patients, with no major adverse events reported.
Conclusions:
- Tigecycline, often used in combination therapy, demonstrates significant clinical and microbiological efficacy in pediatric patients.
- Treatment outcomes are influenced by the specific infection site and the identified microorganism.
- Tigecycline represents a viable therapeutic option for pediatric infections caused by MDR pathogens, with a favorable safety profile.
Introduction:
The incidence of infections caused by multidrug-resistant pathogens is increasing worldwide, resulting in significant morbidity and mortality. Tigecycline has become a good option because it has a broad spectrum of antibacterial activity. This study aimed to reveal the clinical, microbiological, and laboratory outcomes of hospitalized children treated with tigecycline.
Methodology:
We retrospectively collected the medical records of the hospitalized pediatric patients treated with tigecycline from April 1, 2018, to Apr 30, 2023, at Ege University Children's Hospital. Demographic features and clinical and laboratory findings were evaluated to determine the efficacy and safety of tigecycline therapy.
Results:
Sixty-seven patients (65.7% male) with a median age of 6 years (2.5 months-17.5 years) were included. There was an underlying condition in 83.5% of the patients, and 55.2% were immunosuppressed. The most common infections were; lower respiratory tract infections (29.8%), intra-abdominal infections (20.9%), bloodstream infections (17.9%), and soft tissue infections (13.4%), respectively. Acinetobacter spp. (28.4%) was the most isolated microorganism, followed by Klebsiella spp. (19.4%) and Enterococcus spp. (14.9%). Tigecycline was used as a targeted treatment in 76.1% of the patients and was often used as a combination therapy (80.6%) with a median duration of 12 days (range, 2-60 days). Clinical response was achieved in 65.6% of patients, microbiologic response in 62.6%, and treatment failure in 34.3%. No major adverse events were noted during the therapy.
Conclusions:
Tigecycline, which was mostly preferred in combination therapy, had high clinical response and microbiologic eradication rates, but these rates varied according to infection sites and microorganism species.
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