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Tigecycline in intensive care unit infections

Abstract number: P554

Paramythiotou E., Kontopidou F., Papadomichelakis E., Antoniadou A., Poulakou G., Armaganidis A., Giamarellou H.

Objectives: Tigecycline is a novel broad-spectrum glycylcycline antibiotic, which possesses activity against a broad range of Gram-positive, Gram-negative, atypical, anaerobic and antibiotic-resistant bacteria. It has been approved for complicated infections of skin and/or subcutaneous tissues and complicated intra-abdominal infections. For compassionate use it has been given for the treatment of infections caused by multi-resistant organisms. The aim of this study was to assess the efficacy of tigecycline in ICU infections caused by strains resistant to other antibiotics.

Methods: This is a prospective study conducted in the 18-bed medical–surgical ICU of "ATTIKON" university general hospital. Patients with severe ICU infections treated with tigecycline were included. Tigecycline was used either in cases of infections caused by pan-drug resistant Gram-negative microorganisms, including colistin, or as empirical treatment in patients with life-threatening infections which did not respond in other treatment or were colonised by PDR pathogens. Data recorded included demographic characteristics; site of infection, other antibiotics used concomitantly, treatment results after fifteen days follow up, outcome and adverse drug reactions.

Results: Between 12/ 2006 and 11/ 2007 seventeen patients were treated with tigecycline. Among them nine patients were treated for ventilator associated pneumonia (VAP), five for complicated skin or intra-abdominal infection and three for septic shock of unknown origin. Ten patients were treated empirically. Three patients received tigecycline as monotherapy and fourteen received other antimicrobials simultaneously. Seven cases of VAP were due to Acinetobacter baumannii alone and two cases were mixed respiratory infections (Acinetobacter b plus Klebsiella pn) and all of them were cured. Among the rest, one patient was cured and a temporal improvement was noted in 4/7 patients. Most of pathogens were susceptible only to colistin and tigecycline and four patients were infected with colistin-resistant strains. Dose was 50 mg × 2 or 100 mg × 2 IV without adverse effects.

Conclusions: Though the number of patients is small, our results are encouraging about tigecycline use for the treatment of ICU serious infections especially in ventilator-associated pneumonia. Given the problem of MDR pathogens in ICUs, tigecyclin could be an effective treatment choice. However more experience is urgently required.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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