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Survival predictors in patients treated with tygecicline in clinical practice

Abstract number: P1615

Conde-Estévez D., Grau S., Luque S., Horcajada J.P., Alvarez-Lerma F., Mateu-de Antonio J., Urbina O., Knobel H.

Background: Most clinical experience with Tigecycline (TGC) proceeds from clinical trials. The objective of the study was to determinate survival predictor factors in patients treated with TGC.

Methods: Prospective observational study of all patients treated with TGC from april 2007-april 2008 admitted in a 450-bed university hospital.

Measures: demographics, length of stay (LOS), ICU admission, SAPS-II at admission (SAPSII-A) and at TGC beginning (SAPSII-TGC), empirical TGC-therapy, TGC days, patients with previous (PA) and concomitant antibiotics (CA), isolated microorganisms before TGC-treatment (M-TGC), infection site, microbiological eradication (ME), favourable clinical outcome (FCO) and mortality during or 28 days after finishing TGC therapy (M). SAPS-II was transformed in a dichotomic variable (cut-off point 40). Fischer exact test for dichotomic and "U" Mann-Whitney test for continuous variables and a multiple logistic regression for prediction survival were employed.

Results: Patients: 62; male: 32 (51.6%); mean age: 61.6 (SD+15.3); mean LOS: 39.9 (SD+34.1); ICU patients: 24 (38.7%); SAPSII-A: 31.3 (SD+10.4); SAPSII-TGC: 31.2 (SD+11.7), empirical treatment 12 (19.4%); TGC days: 7.5 (SD+5.7); PA: 41 (66.1%); CA: 43 (69.4%); infection site: SSTI 21 (33.9%), intraabdominal 19 (30.6%), low respiratory tract 11 (17.7%), CNS 5 (8.1%), others (9.7%); main M-TGC: Stenotrophomonas maltophilia 9 (14.50%), Escherichia coli 8 (12.9%); FCO: 35 (58.3%), ME 29 (47.5%) and M: 11 (17.7%).

In multivariate analysis, only the lack of isolation of S. maltophilia [OR: 23.1 (CI95%: 3.3–160.5) (p = 0.001)], and SAPS-II-TGC <40 [OR: 13.2 (CI95%:2.1–82.2) (p = 0.006)] were independently associated with survival.

Conclusions:

–Survival predictor factors in patients treated with TGC were a SAPSII-TGC score lower than 40 and lack of S. maltophilia isolation.

–TGC treatment was related to a low mortality considering the high severity of patients.

Session Details

Date: 16/05/2009
Time: 00:00-00:00
Session name: 19th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Helsinki, Finland, 16 - 19 May 2009
Presentation type:
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