Management of complicated infections in the era of antimicrobial resistance: the role of tigecycline

Abstract

Background: Increasing antimicrobial resistance and infection complications pose challenges to optimal antibiotic therapy. Paucity of new antibiotics (and the eventual bacterial resistance they face) highlights the critical need for more appropriate use of broadly effective agents, which may help to thwart the dramatic rise in global resistance. Single agents that can be combined effectively with others, if needed, promise the simplest overall utility. Approved in 2005 to treat complicated skin and intra-abdominal infections, tigecycline is a novel extended-spectrum minocycline derivative that circumvents bacterial resistance, as it is unaffected by efflux pumps and ribosomal protection. However, tigecycline should not be used as empiric monotherapy for treatment of health-care associated infections known or suspected to be owing to Pseudomonas aeruginosa or Proteus spp. Objective: This article summarizes the demonstrated clinical utility of tigecycline so far. Methods: A MEDLINE search examined authoritative published clinical studies, reviews and case reports detailing the clinical record of tigecycline since 2004. Results/conclusion: Tigecycline continues to maintain satisfactory profiles of safety, efficacy and antimicrobial resistance avoidance. Regardless, continued surveillance is needed to detect reduced susceptibility and resistance against both community and nosocomial pathogens. Judicious use of agents reserved for multidrug resistant pathogens is vital to preserve their effectiveness.

Keywords::

• antibiotic
• antimicrobial resistance
• clinical utility
• complicated infections
• ease of use
• tigecycline

Acknowledgments

The author thanks Hessamedin Alimohammadi of Upside Endeavors, LLC, for his medical writing and editorial assistance. No further support other than the noted editorial assistance was provided to the author for the preparation of this manuscript.