Clinical evaluation of tigecycline in the treatment of nosocomial infections in a hospital in Taiwan

Man Tzu Marcie Wu, Hsiang Yin Chen, Tsong Yih Ou, Li Na Kuo, Kuei Ju Cheng, Wen Sen Lee

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: Clinical information on tigecycline use in serious nosocomial infections is limited, and the efficacy is uncertain. The aim of this retrospective study was to assess the utilization pattern and the effectiveness of tigecycline in a tertiary medical center in Taiwan. Methods: A retrospective study of the clinical and microbiological outcome of all patients treated with tigecycline for at least 72 hours over a 2-year period was conducted in a 730-bed teaching hospital. Results: Data from 133 patients with 149 cases of nosocomial infection were analyzed in this assessment. The mean APACHE II score at the initiation of tigecycline therapy was 22.5 ± 8.8, and the mean duration of treatment was 11.4 ± 5.6 days. Pneumonia was the most frequently diagnosed clinical indication for tigecycline use (113 cases, 76%). An overall positive clinical outcome was observed in 75 cases (50%). Multidrug-resistant Acinetobacter baumannii (MDRAB) is the most common organism for tigecycline therapy (n = 59), with a positive clinical outcome of 38% in tigecycline monotherapy, 66% in dualtherapy, and 17% in triple-therapy (p = 0.031). The most commonly used combining agents with tigecycline to treat MDRAB infections were intravenous colistin, inhaled colistin, and cepoferazone/sulbactam, with positive clinical outcome rates of 53%, 100%, and 80%, respectively. Admission to intensive care unit was identified as a predictive factor for negative clinical outcome. Conclusion: Our pneumonia-dominated study population demonstrated a lower clinical improvement rate of tigecycline compared to previous published data. Tigecycline monotherapy is not recommended for MDRAB infection, but colistin or cephoperazone/sulbactam combined with tigecycline seemed to yield a good clinical outcome for MDRAB infection.

Original languageEnglish
Pages (from-to)1030-1036
Number of pages7
JournalInternational Journal of Clinical Pharmacology and Therapeutics
Volume52
Issue number12
DOIs
Publication statusPublished - Dec 1 2014

Fingerprint

Cross Infection
Taiwan
Acinetobacter baumannii
Acinetobacter Infections
Colistin
Therapeutics
Sulbactam
Pneumonia
tigecycline
Retrospective Studies
APACHE
Teaching Hospitals
Intensive Care Units

Keywords

  • Medication use evaluation
  • Nosocomial infections
  • Tigecycline

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Clinical evaluation of tigecycline in the treatment of nosocomial infections in a hospital in Taiwan. / Wu, Man Tzu Marcie; Chen, Hsiang Yin; Ou, Tsong Yih; Kuo, Li Na; Cheng, Kuei Ju; Lee, Wen Sen.

In: International Journal of Clinical Pharmacology and Therapeutics, Vol. 52, No. 12, 01.12.2014, p. 1030-1036.

Research output: Contribution to journalArticle

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abstract = "Objective: Clinical information on tigecycline use in serious nosocomial infections is limited, and the efficacy is uncertain. The aim of this retrospective study was to assess the utilization pattern and the effectiveness of tigecycline in a tertiary medical center in Taiwan. Methods: A retrospective study of the clinical and microbiological outcome of all patients treated with tigecycline for at least 72 hours over a 2-year period was conducted in a 730-bed teaching hospital. Results: Data from 133 patients with 149 cases of nosocomial infection were analyzed in this assessment. The mean APACHE II score at the initiation of tigecycline therapy was 22.5 ± 8.8, and the mean duration of treatment was 11.4 ± 5.6 days. Pneumonia was the most frequently diagnosed clinical indication for tigecycline use (113 cases, 76{\%}). An overall positive clinical outcome was observed in 75 cases (50{\%}). Multidrug-resistant Acinetobacter baumannii (MDRAB) is the most common organism for tigecycline therapy (n = 59), with a positive clinical outcome of 38{\%} in tigecycline monotherapy, 66{\%} in dualtherapy, and 17{\%} in triple-therapy (p = 0.031). The most commonly used combining agents with tigecycline to treat MDRAB infections were intravenous colistin, inhaled colistin, and cepoferazone/sulbactam, with positive clinical outcome rates of 53{\%}, 100{\%}, and 80{\%}, respectively. Admission to intensive care unit was identified as a predictive factor for negative clinical outcome. Conclusion: Our pneumonia-dominated study population demonstrated a lower clinical improvement rate of tigecycline compared to previous published data. Tigecycline monotherapy is not recommended for MDRAB infection, but colistin or cephoperazone/sulbactam combined with tigecycline seemed to yield a good clinical outcome for MDRAB infection.",
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AU - Kuo, Li Na

AU - Cheng, Kuei Ju

AU - Lee, Wen Sen

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