Best tigecycline dosing for treatment of infections caused by multidrug-resistant pathogens in critically ill patients with different body weights

被引:9
作者
Ibrahim, Mohamed M. [1 ]
Abuelmatty, Abdulla M. [2 ]
Mohamed, Gehan H. [3 ]
Nasr, Mohsen A. [4 ]
Hussein, Amal K. [5 ]
Ebaed, Mohy El Deen [6 ]
Sarhans, Hatem A. [5 ]
机构
[1] Menia Univ, Fac Pharm, Dept Clin Pharm, St 532,Bldg 1,Apartment 1, Al Minya, Egypt
[2] Jahra Hosp, Dept Pharm, Jahra, Kuwait
[3] Cairo Univ, Fac Med, Dept Internal Med, Cairo, Egypt
[4] Ain Shams Univ, Fac Med, Dept Internal Med, Cairo, Egypt
[5] Menia Univ, Fac Pharm, Dept Pharmaceut, Al Minya, Egypt
[6] Egyptian Minist Interior, Dept Biochem, Cairo, Egypt
关键词
tigecycline; obese patients; intensive care unit; complicated intra-abdominal infections; complicated skin and soft-tissue infections; EFFICACY; SAFETY; TRIAL;
D O I
10.2147/DDDT.S181834
中图分类号
R914 [药物化学];
学科分类号
100701 ;
摘要
Background: The intensive care unit (ICU) is a center of multidrug-resistant (MDR) pathogens. This is due to overuse of antibiotics in the treatment of critically ill patients. Tigecycline is a broad-spectrum antibiotic that belongs to the glycylcycline group. Tigecycline has been indicated in treatment of complicated intra-abdominal infections (cIAIs) and complicated skin and soft-tissue infections (cSSTIs). Objective: This study was done to discover the best dose regimen of tigecycline in treatment of cSSTIs and cIAIs, especially in patients who are critically ill and obese, for clinical outcomes and safety. Setting: The study was conducted in an adult ICU that consists of 25 beds in a general hospital and was conducted within 2 years. A total of 954 patients were screened in this study. Methods: This was a retrospective cohort study that compared the clinical outcomes of patients: mortality, ICU stay, and safety of using two different dose regimens of tigecycline between patients with different body weight who were treated for infections caused by MDR pathogens in the ICU. The study was conducted within 2 years. All results were collected from patients' files and were analyzed with SPSS version 20. Main outcome: The study was implemented to figure out the best dose regimen of tigecycline to achieve a reduction in mortality, ICU stay, treatment duration, and secondary septic-shock incidence with minimum side effects in treatment of cSSTIs and cIAIs in patients with different body weight. Results: There was a significant improvement in mortality, ICU stay, recurrent infection by the same organism, duration of tigecycline treatment, number of patients who had first negative culture after starting treatment, secondary bacteremia, and secondary septic shock with patients who used high-dose regimens of tigecycline in different subgroups of body weight, with no significant difference in side effects. Conclusion: The use of high-dose tigecycline resulted in a significant enhancement in all clinical outcomes, especially mortality and ICU stay when used in treatment of overweight and obese patients with cSSTIs and cIAIs.
引用
收藏
页码:4171 / 4178
页数:8
相关论文
共 14 条
[1]  
[Anonymous], 2009, BMC PULM MED, DOI DOI 10.1186/1471-2466-9-44
[2]   The efficacy and safety of tigecycline for the treatment of complicated intra-abdominal infections: Analysis of pooled clinical trial data [J].
Babinchak, T ;
Ellis-Grosse, E ;
Dartois, N ;
Rose, GM ;
Loh, E .
CLINICAL INFECTIOUS DISEASES, 2005, 41 :S354-S367
[3]   Carbapenemase-producing Klebsiella pneumoniae in Brooklyn, NY:: molecular epidemiology and in vitro activity of polymyxin B and other agents [J].
Bratu, S ;
Tolaney, P ;
Karumudi, U ;
Quale, J ;
Mooty, M ;
Nichani, S ;
Landman, D .
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2005, 56 (01) :128-132
[4]   High dose tigecycline in critically ill patients with severe infections due to multidrug-resistant bacteria [J].
De Pascale, Gennaro ;
Montini, Luca ;
Pennisi, Mariano Alberto ;
Bernini, Valentina ;
Maviglia, Riccardo ;
Bello, Giuseppe ;
Spanu, Teresa ;
Tumbarello, Mario ;
Antonelli, Massimo .
CRITICAL CARE, 2014, 18 (03)
[5]   Canadian guidelines for body weight classification in adults: application in clinical practice to screen for overweight and obesity and to assess disease [J].
Douketis, JD ;
Paradis, G ;
Keller, H ;
Martineau, C .
CANADIAN MEDICAL ASSOCIATION JOURNAL, 2005, 172 (08) :995-998
[6]   The efficacy and safety of tigecycline in the treatment of skin and skin-structure infections: Results of 2 double-blind phase 3 comparison studies with vancomycin-aztreonam [J].
Ellis-Grosse, EJ ;
Babinchak, T ;
Dartois, N ;
Rose, G ;
Loh, E .
CLINICAL INFECTIOUS DISEASES, 2005, 41 :S341-S353
[7]   Tigecycline: in-vitro performance as a predictor of clinical efficacy [J].
Hawkey, P. ;
Finch, R. .
CLINICAL MICROBIOLOGY AND INFECTION, 2007, 13 (04) :354-362
[8]   Impact of inadequate initial antimicrobial therapy on mortality in infections due to extended-spectrum β-lactamase-producing Enterobacteriaceae -: Variability by site of infection [J].
Hyle, EP ;
Lipworth, AD ;
Zaoutis, TE ;
Nachamkin, I ;
Bilker, WB ;
Lautenbach, E .
ARCHIVES OF INTERNAL MEDICINE, 2005, 165 (12) :1375-1380
[9]   TREATMENT OF MISSING DATA IN MULTIVARIATE-ANALYSIS [J].
KIM, JO ;
CURRY, J .
SOCIOLOGICAL METHODS & RESEARCH, 1977, 6 (02) :215-240
[10]   Randomized Phase 2 Trial To Evaluate the Clinical Efficacy of Two High-Dosage Tigecycline Regimens versus Imipenem-Cilastatin for Treatment of Hospital-Acquired Pneumonia [J].
Ramirez, Julio ;
Dartois, Nathalie ;
Gandjini, Hassan ;
Yan, Jean Li ;
Korth-Bradley, Joan ;
McGovern, Paul C. .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2013, 57 (04) :1756-1762