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Aslan K, Kiliç Ö, Kiral E, Bozan G, Bör Ö, Dinleyici EÇ. Clinical and laboratory responses to tigecycline in children. J Clin Pharm Ther 2022; 47:1585-1590. [DOI: 10.1111/jcpt.13708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/13/2022] [Accepted: 05/18/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Kaan Aslan
- Department of Pediatrics Eskişehir Osmangazi University Medical Faculty Eskişehir Turkey
| | - Ömer Kiliç
- Division of Pediatric Infectious Diseases Eskişehir Osmangazi University Medical Faculty Eskişehir Turkey
| | - Eylem Kiral
- Division of Pediatric Intensive Care Unit Eskişehir Osmangazi University Medical Faculty Eskişehir Turkey
| | - Gürkan Bozan
- Division of Pediatric Intensive Care Unit Eskişehir Osmangazi University Medical Faculty Eskişehir Turkey
| | - Özcan Bör
- Division of Pediatric Hematology‐Oncology Eskişehir Osmangazi University Medical Faculty Eskişehir Turkey
| | - Ener Çağrı Dinleyici
- Division of Pediatric Intensive Care Unit Eskişehir Osmangazi University Medical Faculty Eskişehir Turkey
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Yang M, Gao H, Wang X, Qian S. Tigecycline treatment in a liver transplant infant with carbapenem-resistant Escherichia coli infection: Case report. Medicine (Baltimore) 2019; 98:e17339. [PMID: 31574872 PMCID: PMC6775363 DOI: 10.1097/md.0000000000017339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION During the past decade, the rate of carbapenem resistance among Enterobacteriaceae, mostly in Escherichia coli and Klebsiella pneumoniae, has significantly increased worldwide. It is a great challenge for the choice of drug treatment especially in children.Tigecycline is the first drug in the glycylcycline class of antibiotics. For children, the China Food and Drug Administration and US Food and Drug Administration postulated that tigecycline is not recommended. It must be used only as salvage therapy for life-threatening infections in critically ill children who have no alternative treatment options. PATIENT CONCERNS A male pediatric case of 4.5 months was blood stream infection after liver transplantation. The blood cultures obtained grew Gram-negative rods, which reportedly grew a strain of extended-spectrum β-lactamase and carbapenemases-producing Escherichia coli within 10 hours. All bacterial isolates were found to be resistant to all antimicrobial agents except aminoglycosides and tigecycline. DIAGNOSES Complicated intra-abdominal infection, central line-associated blood stream infection. INTERVENTIONS The blood stream infection with carbapenem-resistant Escherichia coli after liver transplantation was cured by tigecycline. OUTCOMES The patient's condition continued to improve, then transferred to general ward. CONCLUSION The following report, to our knowledge, is the youngest liver transplantation patient who used tigecycline treatment around the world. It provides reference and experience for the use of tigecycline in infants with severe infections.
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Affiliation(s)
| | - Hengmiao Gao
- PICU, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | | | - Suyun Qian
- PICU, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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Preliminary experience with tigecycline treatment for severe infection in children. Eur J Pediatr 2018; 177:1489-1496. [PMID: 30008076 DOI: 10.1007/s00431-018-3208-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 06/02/2018] [Accepted: 07/09/2018] [Indexed: 02/01/2023]
Abstract
Severe infection is a primary cause of mortality in children facing challenges from multidrug-resistant (MDR) pathogens, particularly MDR Acinetobacter baumannii. Tigecycline has an expanded spectrum of antibacterial activity, and some successful instances of its use in children have been reported. We conducted a retrospective chart review of children treated at a tertiary hospital between May 1, 2012 and May 1, 2017 to examine the efficacy and safety of tigecycline in children with severe infection. A total of 110 patients (69 males) were enrolled in this study, including 46 MDR A. baumannii infection patients, encompassing 51 A. baumannii strains. Totally, the median duration of tigecycline therapy was 10 days (range, 2-47 days), with a clinical improvement rate of 47.27% (52/110). In A. baumannii infection group, the clinical improvement rate was 50% (23/46) and the microbiology eradication rate was 50.98% (26/51). No adverse events were reported during therapy; however, in one case, a 9-year-old boy with hematologic disease developed tooth discoloration.Conclusion: Although some patients benefited from tigecycline, the efficacy and safety of tigecycline should not be overvalued. Additional data from randomized controlled trials are required to assess the administration of tigecycline. What is Known: • Severe infection is a primary cause of mortality in pediatric patients and its treatment is facing challenges from an increasing number of multidrug-resistant (MDR) pathogens. • Tigecycline has an expanded spectrum of antibacterial activity. • Several case reports have indicated that tigecycline could be used as a salvage therapy in children when options are limited or non-existent. What is New: • We found that rate of clinical improvement was different in various groups of different infection. The efficacy of tigecycline should not be overvalued. • Six dosage models and different infection types were observed in our series, with different improvement and eradication rate, indicating that more data are required to identify a proper tigecycline dosage.
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Carvalho RVD, Lima FFDS, Santos CSD, Souza MCD, Silva RSD, Mattos-Guaraldi ALD. Central venous catheter-related infections caused by Corynebacterium amycolatum and other multiresistant non-diphtherial corynebacteria in paediatric oncology patients. Braz J Infect Dis 2018; 22:347-351. [PMID: 30102894 PMCID: PMC9428009 DOI: 10.1016/j.bjid.2018.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 07/13/2018] [Accepted: 07/15/2018] [Indexed: 11/26/2022] Open
Abstract
Bloodstream and venous catheter-related corynebacterial infections in paediatric patients with haematological cancer were investigated from January 2003 to December 2014 at the Brazilian National Cancer Institute in Rio de Janeiro, Brazil. We observed that during cancer treatment, invasive corynebacterial infections occurred independent of certain factors, such as age and gender, underlying diseases and neutropenia. These infections were ssscaused by Corynebacterium amycolatum and other non-diphtherial corynebacteria. All cases presented a variable profile of susceptibility to antimicrobial agents, except to vancomycin. Targeted antibiotic therapy may contribute to catheters maintenance and support quality of treatment. Non-diphtherial corynebacteria must be recognized as agents associated with venous access infections. Our data highlight the need for the accurate identification of corynebacteria species, as well as antimicrobial susceptibility testing.
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Affiliation(s)
- Ricardo Vianna de Carvalho
- Universidade Estadual do Rio de Janeiro (UERJ), Faculdade de Ciências Médicas, Laboratório de Difteria e Corynebacteria de Relevância Clínica, Rio de Janeiro, RJ, Brazil; Ministério da Saúde, Fundação Nacional de Saúde, Centro de Referência e Pesquisa em Difteria, Brasília, DF, Brazil; Instituto Nacional do Câncer , Rio de Janeiro, RJ, Brazil.
| | | | - Cíntia Silva Dos Santos
- Universidade Estadual do Rio de Janeiro (UERJ), Faculdade de Ciências Médicas, Laboratório de Difteria e Corynebacteria de Relevância Clínica, Rio de Janeiro, RJ, Brazil; Ministério da Saúde, Fundação Nacional de Saúde, Centro de Referência e Pesquisa em Difteria, Brasília, DF, Brazil
| | - Mônica Cristina de Souza
- Universidade Estadual do Rio de Janeiro (UERJ), Faculdade de Ciências Médicas, Laboratório de Difteria e Corynebacteria de Relevância Clínica, Rio de Janeiro, RJ, Brazil; Ministério da Saúde, Fundação Nacional de Saúde, Centro de Referência e Pesquisa em Difteria, Brasília, DF, Brazil
| | - Rondinele Santos da Silva
- Universidade Estadual do Rio de Janeiro (UERJ), Faculdade de Ciências Médicas, Laboratório de Difteria e Corynebacteria de Relevância Clínica, Rio de Janeiro, RJ, Brazil; Ministério da Saúde, Fundação Nacional de Saúde, Centro de Referência e Pesquisa em Difteria, Brasília, DF, Brazil
| | - Ana Luiza de Mattos-Guaraldi
- Universidade Estadual do Rio de Janeiro (UERJ), Faculdade de Ciências Médicas, Laboratório de Difteria e Corynebacteria de Relevância Clínica, Rio de Janeiro, RJ, Brazil; Ministério da Saúde, Fundação Nacional de Saúde, Centro de Referência e Pesquisa em Difteria, Brasília, DF, Brazil
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Lin S, Zhang C, Ye S. Preliminary experience of tigecycline treatment for infection in children with hematologic malignancies. Int J Clin Pharm 2018; 40:1030-1036. [PMID: 30051224 DOI: 10.1007/s11096-018-0690-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 07/05/2018] [Indexed: 11/27/2022]
Abstract
Background Severe infection is life-threatening in children with hematologic malignancies and its treatment is challenging because of an increasing number of multidrug-resistant pathogens. Tigecycline has an expanded antibacterial activity spectrum; some successful cases of tigecycline treatment have been reported in the literature. Objective To examine the efficacy and safety of tigecycline in children. Setting Department of hematologic malignancies in a tertiary hospital. Method A retrospective chart review from May 1, 2012 to May 1, 2017. The patients were identified by the hospital information system and a custom-made Microsoft Excel 2007 database of patients was created to record demographic and medical data. Main outcome measure Efficacy and safety of tigecycline use in severe infection children with hematologic malignancies. Results Thirty-seven patients were enrolled and the predominant diagnosis was acute lymphoblastic leukemia. The median duration of tigecycline therapy was 9 days. Most prescriptions were empirical. Eighteen patients received a maintenance dose of 2 mg/kg q12 h, without a loading dose. Sulperazone was the most frequently prescribed concomitant drug. At the end of tigecycline therapy, improvement was observed in 48.7% of cases. After treatment, interleukin-10 levels notably decreased. The only reported adverse event was a case of tooth discoloration. Conclusion Tigecycline can be used as salvage therapy in children with hematologic malignancy and seems tolerable. Prospective controlled studies are required to definitively evaluate the efficacy and safety of tigecycline in children.
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Affiliation(s)
- Shupeng Lin
- Division of Hematology-Oncology, Children's Hospital Zhejiang University School of Medicine, No. 57, Zhugan Road, Hangzhou, 310003, China
| | - Chenmei Zhang
- Department of Pediatric Intensive Care Unit, Children's Hospital Zhejiang University School of Medicine, No. 3333, Binsheng Road, Hangzhou, 310052, China
| | - Sheng Ye
- Department of Pediatric Intensive Care Unit, Children's Hospital Zhejiang University School of Medicine, No. 3333, Binsheng Road, Hangzhou, 310052, China.
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Iosifidis E, Violaki A, Michalopoulou E, Volakli E, Diamanti E, Koliouskas D, Antachopoulos C, Drossou-Agakidou V, Sdougka M, Roilides E. Use of Tigecycline in Pediatric Patients With Infections Predominantly Due to Extensively Drug-Resistant Gram-Negative Bacteria. J Pediatric Infect Dis Soc 2017; 6:123-128. [PMID: 27000866 DOI: 10.1093/jpids/piw009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 02/09/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND. Emergence of extensively drug-resistant (XDR) bacteria has forced clinicians to use off-label antimicrobial agents such as tigecycline. We present our experience on salvage use of tigecycline for the treatment of infections caused by XDR Gram-negative bacteria in critically ill children and review published cases. METHODS. We conducted a retrospective chart review in pediatric departments of a tertiary level hospital from January 2009 to May 2014. Patients were identified using pharmacy database. For the literature review, relevant articles were identified from PubMed. RESULTS. In our case series, 13 children (7 males) with a median age of 8 years (range, 2.5 months-14 years) received tigecycline for ≥2 days as treatment for healthcare-associated infections including 5 bacteremias, 6 lower respiratory tract infections, and 3 other infections. Isolated pathogens were XDR Gram-negative bacteria except 1. A loading dose (range, 1.8-6.5 mg/kg) was given in all except 2 cases. Maintenance dose was given at 1-3.2 mg/kg q12 h. Other antimicrobials including colistin and aminoglycosides (85% and 62%, respectively) were coadministered to all patients. No serious adverse events were detected in these very ill children. Twenty cases of children treated with tigecycline were previously published, mostly for multidrug-resistant/XDR bacteria. An episode of acute pancreatitis and neutrophil engraftment delay in 2 cases were reported during tigecycline treatment. Analyzing reported and all our cases together, mortality in bloodstream infections was 86%, whereas in nonbacteremic cases it was 24% (P = .009). CONCLUSIONS. Tigecycline, given at the range of administered doses as salvage therapy and in combination with other antimicrobial agents, seemed to be well tolerated in a series of mainly critically ill pediatric patients and demonstrated relatively good clinical response in nonbacteremic patients.
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Affiliation(s)
| | | | | | | | - Elisavet Diamanti
- 1st Department of Neonatology and Neonatal Intensive Care Unit, Medical Faculty, Aristotle University School of Health Sciences, and
| | | | | | - Vasiliki Drossou-Agakidou
- 1st Department of Neonatology and Neonatal Intensive Care Unit, Medical Faculty, Aristotle University School of Health Sciences, and
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Mastrolia MV, Galli L, De Martino M, Chiappini E. Use of tigecycline in pediatric clinical practice. Expert Rev Anti Infect Ther 2017; 15:605-612. [PMID: 28395551 DOI: 10.1080/14787210.2017.1318064] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Tigecycline, a derivative of minocycline, is an extended-spectrum antimicrobial agent. It has a restricted approval field in children and the experience of its adoption in clinical practice is reserved for cases of challenging infections. The aim of this review was to summarize evidence regarding the use of tigecycline in infants and children, focusing on the drug's clinical efficacy data and tolerability profile. Areas covered: We have conducted a literature search of the Cochrane Library, EMBASE, and MEDLINE databases, from their inception through 5 January 2017, using the following terms: tigecycline, newborn, infant, child, pediatrics, adolescent, human, clinical trial, and case report. Articles were excluded if they were redundant or not pertinent. Bibliographies of all relevant articles were also evaluated. Seventeen publications were included: 1 pharmacokinetic study, 16 case reports. In the selected publications, the patients' mean age was 4.45 years, 38.7% of children was <3 years old and favorable clinical response was achieved in 74.2% of cases. Expert commentary: Tigecycline may be a considerable option in life-threatening infections in pediatric patients. Its administration is well tolerated and has demonstrated a good clinical response in nonbacteremic patients. However, the available clinical records are limited and more studies are needed.
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Affiliation(s)
- Maria Vincenza Mastrolia
- a Pediatric Infectious Disease Unit , Anna Meyer Children's University Hospital , Florence , Italy
| | - Luisa Galli
- a Pediatric Infectious Disease Unit , Anna Meyer Children's University Hospital , Florence , Italy
| | - Maurizio De Martino
- a Pediatric Infectious Disease Unit , Anna Meyer Children's University Hospital , Florence , Italy
| | - Elena Chiappini
- a Pediatric Infectious Disease Unit , Anna Meyer Children's University Hospital , Florence , Italy
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Xu Z, Yan Y, Li Z, Qian L, Gong Z. The Antibiotic Drug Tigecycline: A Focus on its Promising Anticancer Properties. Front Pharmacol 2016; 7:473. [PMID: 27994551 PMCID: PMC5133451 DOI: 10.3389/fphar.2016.00473] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 11/21/2016] [Indexed: 02/05/2023] Open
Abstract
Tigecycline (TIG), the first member of glycylcycline bacteriostatic agents, has been approved to treat complicated infections in the clinic because of its expanded-spectrum antibiotic potential. Recently, an increasing number of studies have emphasized the anti-tumor effects of TIG. The inhibitory effects of TIG on cancer depend on several activating signaling pathways and abnormal mitochondrial function in cancer cells. The aim of this review is to summarize the cumulative anti-tumor evidence supporting TIG activity against different cancer types, including acute myeloid leukemia (AML), glioma, non-small cell lung cancer (NSCLC), among others. In addition, the efficacy and side effects of TIG in cancer patients are summarized in detail. Future clinical trials are also to be discussed that will evaluate the security and validate the underlying the tumor-killing properties of TIG.
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Affiliation(s)
- Zhijie Xu
- Department of Pathology, Xiangya Hospital, Central South UniversityChangsha, China; Department of Pathology, School of Basic Medicine, Central South UniversityChangsha, China
| | - Yuanliang Yan
- Department of Pharmacy, Xiangya Hospital, Central South UniversityChangsha, China; Institute of Hospital Pharmacy, Central South UniversityChangsha, China
| | - Zhi Li
- Center for Molecular Medicine, Xiangya Hospital, Key Laboratory of Molecular Radiation Oncology of Hunan Province, Central South University Changsha, China
| | - Long Qian
- Department of Pharmacy, Xiangya Hospital, Central South UniversityChangsha, China; Institute of Hospital Pharmacy, Central South UniversityChangsha, China
| | - Zhicheng Gong
- Department of Pharmacy, Xiangya Hospital, Central South UniversityChangsha, China; Institute of Hospital Pharmacy, Central South UniversityChangsha, China
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Natrajsetty HSS, Vijayalakshmi IB, Narasimhan C, Manjunath CN. Purulent pericarditis with quadruple valve endocarditis. AMERICAN JOURNAL OF CASE REPORTS 2015; 16:236-9. [PMID: 25904083 PMCID: PMC4410722 DOI: 10.12659/ajcr.893072] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Patient: Male, 7 Final Diagnosis: Purulent pericarditis with quadruple valve endocarditis Symptoms: — Medication: (4S,4aS,5aR,12aS)-9-[2-(tert-butylamino)acetamido]-4,7 bis(dimethylamino)-1,4,4a,5,5a,6,11,12aoctahydro-3,10,12,12a-tetrahydroxy-1,11-dioxo-2 naphthacenecarboxamide Clinical Procedure: Pericardiocentisis Specialty: Cardiology
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Affiliation(s)
| | - Ishwarappa B Vijayalakshmi
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
| | - Chitra Narasimhan
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
| | - Cholenahalli N Manjunath
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India
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Olender A. Antibiotic resistance and detection of the most common mechanism of resistance (MLSB) of opportunistic Corynebacterium. Chemotherapy 2014; 59:294-306. [PMID: 24480817 DOI: 10.1159/000357467] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 11/20/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Determination of antibiotic resistance of opportunistic Corynebacterium colonizing the nose that cause infections and evaluation of the applicability of a simple method for detecting the most common constitutive-type resistance to macrolides, lincosamides and streptogramin B (MLSB). METHODS 70 isolates colonizing the nose and 70 clinical isolates of various infection sites were used and identified using APICoryne and 16S rRNA. Minimal inhibitory concentrations (MICs) were determined (Etest) for 12 antibiotics. MLSB was defined based on MIC, a simple method using two disks (erythromycin/clindamycin) and detection of the gene erm X (PCR). RESULTS There was a high percentage--in both groups at the same level--of strains with MLSB (88.5% colonizing the nose and 87.1% causing infections). Detection with the phenotypic method MLSB was confirmed genetically (erm X) in all cases. In both groups, a high percentage of resistance was found to trimethoprim/sulfamethoxazole (in both groups 71.4%), chloramphenicol (nose 44.2%/infections 37.1%), tetracycline (28 and 45.7%) and β-lactam antibiotics (18.5 and up to 32.8%). CONCLUSION Differences in antibiotic resistance were found between strains colonizing the respiratory tract and various infections. Isolates from infections more frequently exhibited multidrug resistance. The possibility of using a simple method was confirmed for MLSB detection, which can be applied to determine drug resistance in routine microbiological diagnostics of infections caused by opportunistic Corynebacterium.
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Affiliation(s)
- Alina Olender
- Department of Medical Microbiology, Medical University of Lublin, Lublin, Poland
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Du X, Fu Y, Yu Y. Tigecycline treatment of infection caused by KPC-producing Escherichia coli in a pediatric patient. Ann Clin Microbiol Antimicrob 2013; 12:19. [PMID: 23941473 PMCID: PMC3851780 DOI: 10.1186/1476-0711-12-19] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 08/11/2013] [Indexed: 12/02/2022] Open
Abstract
Tigecycline shows great antimicrobial activity against both Gram-positive and Gram-negative bacteria, and has been considered to be an appropriate choice in controlling infection caused by multi-drug resistant (MDR) pathogens, such as carbapenemase-producing Enterobacteriaceae (CPE). Although many clinical trials evaluate the efficacy and safety of tigecycline on adults, rare reports recommend tigecycline to treat pediatric patient. In this study, we presented a clinical case with tigecycline as an anti-infectious agent on a 14-year-old child who was suffering from infection of intraperitoneal abscess caused by Klebsiella pneumoniae carbapenemases (KPC)-producing Escherichia coli with extreme drug resistant profile. By accessing the clinical outcome and efficacy of the patient, and the side effects of tigecycline, our research explored the documented experience of tigecycline on controlling infection caused by CPE isolate in children.
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Affiliation(s)
- Xiaoxing Du
- Department of Infectious Diseases, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
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Avkan-Oguz V, Yapar N, Alp-Cavus S, Demir Onder K, Aktas E, Gulay Z, Cakır N. Clinical and microbiological efficacy of tigecycline for complicated skin-soft-tissue and intra-abdominal infections in a Turkish university hospital. Int J Clin Pract 2013; 67:505-11. [PMID: 23679904 DOI: 10.1111/ijcp.12070] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Tigecycline, a new glycylcycline antimicrobial agent, is indicated for the treatment of complicated skin structure infection (cSSTI), intra-abdominal infection (cIAI) and community acquired pneumonia. We aimed to evaluate the clinical and microbiological data together about tigecycline therapy. METHODS Patients with cIAIs and cSSTIs were included in a prospective, observational follow-up. Patient follow-up forms were developed and clinical and microbiological data were recorded. RESULTS Of the 107 patients, 67 had cSSTIs, 40 had cIAIs. Tigecycline was used empirically in 37.5% of cIAIs and in 50.7% of cSSTIs. In 85.0% of the patients with cIAI and in 73.1% of the patients with cSSTI, clinical and/or microbiological response could be achieved. A drug change was made in 26.9% and 7.5% of the patients with cSSTI and cIAI respectively. Superinfection was detected in 14.9% of the cSSTI and 7.5% of the cIAI patients. CONCLUSION As a result, tigecycline can be safely used in the treatment of different infections. Compared with cSSTIs, the treatment response is better and the duration of treatment is shorter in cIAIs. However, MIC value must be determined at any rate if tigecycline is to be used in the treatment of Acinetobacter (MDR Acinetobacter, in particular) infections. Clinical cure and microbiological eradication rate of tigecycline therapy changes according to different clinical diagnosis and microorganism.
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Affiliation(s)
- V Avkan-Oguz
- Dokuz Eylul University School of Medicine Department of Infectious Diseases and Clinical Microbiology, Izmir, Turkey.
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Antimicrobial susceptibility among Gram-positive organisms collected from pediatric patients globally between 2004 and 2011: results from the Tigecycline Evaluation and Surveillance Trial. J Clin Microbiol 2013; 51:2371-8. [PMID: 23678070 DOI: 10.1128/jcm.00157-13] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The Tigecycline Evaluation and Surveillance Trial (TEST) was designed to monitor global longitudinal changes in bacterial susceptibility to a panel of antimicrobial agents, including tigecycline. In this study, we examine susceptibility among Gram-positive isolates collected from pediatric patients globally between 2004 and 2011. A total of 9,422 Gram-positive isolates were contributed by 1,255 centers, predominantly from Europe and North America. One-third of Staphylococcus aureus isolates were methicillin resistant, peaking in prevalence in 2007. All S. aureus isolates (n = 3,614) were susceptible to linezolid, tigecycline, and vancomycin; minocycline, imipenem, and meropenem were also highly active (>92% susceptibility). Ampicillin and penicillin susceptibility increased significantly during the study period (P < 0.0001 for both). Streptococcus pneumoniae isolates (n = 3,373) were highly susceptible to vancomycin (100%), linezolid (>99%), and levofloxacin and tigecycline (both >96%); imipenem susceptibility was low (32%) in Africa while minocycline susceptibility was low in Asia-Pacific Rim (38%). Penicillin resistance occurred in one-fifth of all S. pneumoniae isolates, with penicillin susceptibility ranging from 14% in Africa to 65% in Europe. Streptococcus agalactiae isolates (n = 1,056) were highly susceptible to most antimicrobials, although only 16% were susceptible to minocycline. Enterococcus faecalis isolates (n = 1,112) were highly susceptible (>97%) to ampicillin, linezolid, penicillin, tigecycline, and vancomycin globally, but only 34% were minocycline susceptible; minocycline susceptibility decreased significantly from 2004 to 2011 (P < 0.001). Tigecycline and linezolid were highly active against Enterococcus faecium (n = 267) globally (100% and 98% susceptible, respectively). Tigecycline and linezolid were highly active against Gram-positive pathogens from pediatric patients in TEST 2004 to 2011, with vancomycin and the carbapenems performing well against most pathogens.
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Borghorst S, Boos J. Tigecyclin (Tygacil®) in der pädiatrischen Anwendung. Monatsschr Kinderheilkd 2011. [DOI: 10.1007/s00112-011-2530-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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