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Successful salvage therapy with tigecycline after linezolid failure in a liver transplant recipient with MRSA pneumonia

Pulmonary infections are a significant cause of morbidity and mortality after liver transplantation. Infections with methicillin‐resistant Staphylococcus aureus (MRSA) have increased in the last 10 years. Mortality may exceed 80% in liver transplant recipients who develop MRSA pneumonia. A 57‐year‐old male following living‐donor liver transplantation developed a right‐sided MRSA pneumonia 6 weeks after transplantation, which required artificial ventilation for 14 weeks. Initially, pneumonia was treated with linezolid. However, after 12 days under current therapy, the infection spread out to both lungs. At that time. we initiated the treatment with tigecycline. Under this therapy, the patient could be cured from MRSA pneumonia and was extubated. We detected no tigecycline related hepatotoxic effect. In conclusion, this case suggests that tigecycline may be useful in the salvage therapy of pneumonia due to MRSA after linezolid failure. Liver Transpl 12:1689–1692, 2006. © 2006 AASLD.