Efficacy of tigecycline for the treatment of complicated skin and soft-tissue infections in real-life clinical practice from five European observational studies.

Abstract

OBJECTIVES:

Tigecycline is an approved treatment for complicated skin and soft-tissue infections (cSSTIs). The efficacy of tigecycline as monotherapy or in combination with other antibacterials in the treatment of cSSTI in routine practice is described.

PATIENTS AND METHODS:

Individual patient-level data were pooled from five European observational studies (July 2006 to October 2011).

RESULTS:

A total of 254 cSSTI patients who received tigecycline were included (mean age 63.2 ± 14.9 years). Of these, 34.4% were in intensive care units, 54.5% acquired their infection in hospital and 90.9% had at least one comorbidity. Infection most commonly affected the limbs (62.4%) and 43.8% of infections were classified as necrotizing. The mean Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores at the beginning of treatment were 15.0 ± 7.9 (n = 205) and 5.8 ± 3.9 (n = 32), respectively, indicating high disease severity. Staphylococcus aureus (52.7%), Escherichia coli (18.0%) and Enterococcus faecium (12.0%) were the most frequently isolated pathogens; 32.9% of infections were polymicrobial and 30.5% were due to resistant pathogens. Overall, 71.8% received tigecycline as monotherapy and 28.2% as combination therapy for a mean duration of 12 days. Clinical response rates at the end of treatment were 79.6% for all patients who received the standard dosage (183/230), 86.7% for patients who received tigecycline as monotherapy (143/165), 75.0% for patients with a nosocomial infection (96/128), 75.3% for patients with an APACHE II score >15 (61/81) and 58.3% for patients with a SOFA score ≥ 7 (7/12).

CONCLUSIONS:

In these real-life studies, tigecycline, alone and in combination, achieved favourable clinical response rates in patients with cSSTI with a high severity of illness.

• Authors: Philippe Montravers, Matteo Bassetti, Hervé Dupont, Christian Eckmann, Wolfgang R Heizmann, Xavier Guirao, Miguel Sánchez García, Maria Rita Capparella, Damien Simoneau, Klaus Friedrich Bodmann
• Journal: The Journal of antimicrobial chemotherapy (J Antimicrob Chemother) Vol. 68 Suppl 2 Pg. ii15-24 (Jul 2013) ISSN: 1460-2091 [Electronic] England
• PMID: 23772042 (Publication Type: Journal Article, Meta-Analysis, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Tigecycline
• Minocycline

Topics

• Adult
• Aged
• Aged, 80 and over
• Anti-Bacterial Agents (therapeutic use)
• Drug Therapy, Combination (methods)
• Europe
• Female
• Gram-Negative Bacterial Infections (drug therapy)
• Gram-Positive Bacterial Infections (drug therapy)
• Humans
• Male
• Middle Aged
• Minocycline (analogs & derivatives, therapeutic use)
• Skin Diseases, Bacterial (drug therapy)
• Soft Tissue Infections (drug therapy)
• Tigecycline
• Treatment Outcome
• Young Adult