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Clinical use of tigecycline in a university hospital

Background Tigecycline, a glycylcycline antibiotic, is indicated in adults for the treatment of complicated skin and soft tissue infections and complicated intra-abdominal infections. FDA and EMA have reviewed their indications. Purpose The aim of this study is to describe the use of tigecycline in our hospital. Materials and methods The patient's clinical histories were reviewed to verify the correct use of tigecycline. A descriptive observational study was performed to evaluate the use of tigecycline over a 3 months period. Several variables were studied, including patient information, diagnosis, evaluation of empirical treatment, duration of treatment or change of antibiotic and clinical resolution. Results 39 patients, 22 men and 17 women, with mean age 61 years old (range 49-72) were investigated. 29 (74,4%) were sent to the Urgency Service. Co-morbilities were: diabetes mellitus (25,6%), renal failure (23,1%), cancer (18%), congestive cardiac failure (15,8%), chronic obstructive pulmonary disease (10%) and peripheral arteriopathy (10%). The majority of the treatments were prescribed in medical intensive care units. Of the 39 patients: 15 were assessed in Anaesthesia and Reanimation Unit and 13 in the Intensive Care. An internal medicine physician specialising in infectious diseases prescribed tigecycline to 5 patients (12,8%). And the rest were from surgical units. The most common infections were: intra-abdominal infection (35,8%), skin and soft tissue (17,9%), bacteraemia (15,4%), pneumonia (10,3%), fever syndrome (7,7%), central catheter infections (5,1%), central nervous system infection (2,6%), respiratory infections (2,6%), and not identified (12,8%). In 18 patients (46,2%) treatment was suspended due to clinical resolution, 2 of them were de-escalated. 15 patients (38%) died during the study period. In 6 patients were not collected. Conclusions Tigecycline was prescribed to many infections, most of them were not indicated. It was necessary to insist on dissemination of the protocols of empirical treatment to ensure the proper use of antibiotics.