Tigecycline for the treatment of infections due to resistant Gram-positive organisms

Abstract

Tigecycline is a novel compound in the antimicrobial class known as the glycylcyclines. In vitro studies have shown it to have activity against the vast majority of Gram-positive pathogens, including multi-drug resistant Staphylococcus aureus and vancomycin-resistant enterococci. Tigecycline has also shown excellent in vitro activity against a broad range of Gram-negative enteric organisms including strains resistant to other antimicrobials as well as anaerobes. Tigecycline is not affected by the ribosomal protection and efflux mechanisms transmitted by the known tetracycline resistance genes. Tigecycline represents an exciting new class of glycylcycline antimicrobial agents for the treatment of multi-drug resistant Gram-positive bacteria. Although its broad spectrum of activity, which also includes Gram-negative enterics, makes it a candidate for empiric therapy for intra-abdominal infections, its spectrum against multi-drug resistant Gram-positive organisms makes it a very attractive choice for empiric treatment of Gram-positive infections in patients at risk for resistant strains. The two pivotal Phase II clinical trials involving complicated skin and soft tissue infections and intra-abdominal infections have shown the drug to be safe and effective.

Keywords::

• complicated skin and soft tissue infection
• efflux
• glycylcycline
• methicillin-resistant Staphylococcus aureus
• ribosomal protection
• tetracycline
• tigecycline
• vancomycin-resistant enterococci