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TIGECYCLINE (TYGACIL)

Tigecycline is the first glycylcycline, a new type of antibiotic that exhibits potent activity against a variety of resistant bacteria.

Tigecycline exhibits potent activity against a broad spectrum of bacteria, including strains that have become resistant to commonly used antibiotics such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). Tigecycline was developed to circumvent two major resistance mechanisms, efflux pumps and ribosomal protection, which have limited the use of tetracyclines. Efflux pumps cause the antibiotic to be quickly pumped out of the bacteria, significantly decreasing the antibiotic’s effectiveness. Ribosomal protection blocks antibiotics from interfering with bacterial protein synthesis.

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Role of tigecycline in the treatment of urinary tract infections: a systematic review of published case reports

The emergence of multi-drug resistance in urinary tract infections (UTIs) poses a significant therapeutic challenge. This is especially true for developing countries where indiscriminate usage of antibiotics is common. The choice of antimicrobials for UTIs is dependent not only on the organisms and their minimum inhibitory concentrations (MICs), but also on the ability of antimicrobials to achieve adequate concentration in the urine. Drugs such as beta-lactams, aminoglycosides, nitrofurantoin and fluoroquinolones have traditionally been the mainstay of treatment.

However, with increasing rates of drug resistance, clinicians have been forced to look for alternatives such as newer beta-lactam/ beta-lactam inhibitors (BL-BLI) combinations, as well as other antibiotics, such as fosfomycin and colistin. In cases where clinical conditions, adverse effect profile, cost and availability preclude using these second-line drugs, rescue drugs such as tigecycline are the only available option. Tigecycline is approved for routine use in intra-abdominal infections and skin-soft tissue infections. Since tigecycline was thought to have poor urinary concentration, its use in UTIs has never been encouraged. Therefore, in this systematic review, we aimed to summarize the available literature on the use of tigecycline for UTIs.

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Appropriate use of tigecycline

Tigecycline, the first of a new class of broad-spectrum antibiotics, the glycylcyclines, was recently licensed in South Africa for the parenteral treatment of adult patients with complicated intra-abdominal infections (cIAIs) and complicated skin and soft-tissue infections (cSSTIs). This statement addresses important aspects of the new agent, including pharmacokinetics, mode of action and antibacterial spectrum, summarises key clinical trial data, and highlights appropriate use of the drug. Several other important considerations are also briefly addressed.

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What Tigecycline is and what it is used for

Tigecycline is an antibiotic of the glycylcycline group that works by stopping the growth of bacteria that cause infections. Your doctor has prescribed tigecycline because you or your child at least 8 years old has one of the following types of serious infections: Complicated infection of the skin and soft tissues (the tissue below the skin), excluding diabetic foot infections. Complicated infection in the abdomen Tigecycline is only used when your doctor thinks other antibiotics are not suitable.

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Tigecycline (Tygacil), the First in a New Class of Antibiotic

Tigecycline is the first FDA-approved agent in a new class of antibiotics, glycylcyclines, a class closely related to the tetracyclines. Tigecycline was specifically developed to provide broad-spectrum coverage while overcoming two of the more common resistance mechanisms associated with tetracycline antibiotics: drug efflux and ribosomal protection. This combination of activity and lack of resistance allows tigecycline to be used for many infections that other antibiotics may not be able to address.

Tigecycline is unique among the small group of antibiotics used for multidrug-resistant Gram-positive infections because it also possesses activity against Gram-negative organisms. Tigecycline has activity against a number of Gram-positive organisms, including MRSA and Enterococcus faecalis, and Gram-negative organisms, including ESBL-producing bacteria, Acinetobacter spp., and Stenotrophomonas spp. Of note, tigecycline does not have antipseudomonal activity. Tigecycline also possesses antianaerobic activity.