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.