Part III: Guidelines for Selected Antimicrobial Use

3.4 Tigecycline

Tigecycline is a tetracycline derivative and belongs to the antibiotic group glycylcycline. [192]
Its activity includes MRSA, VRE, Escherichia coli, Klebsiella pneumoniae, and rapidly growing, nontuberculous mycobacteria. [193]
Morganella morganii, Proteus mirabilis, Proteus penneri, Proteus vulgaris, Providencia rettgeri, Providencia stuartii, and Pseudomonas aeruginosa are intrinsically resistant to tigecycline. [194]
Tigecycline can be used to treat complicated skin and soft tissue infections, complicated intra-abdominal infections, and community-acquired bacterial pneumonia in adults.
Limitation of use

Warnings and reports have been published on the higher all-cause mortality observed in patients treated with tigecycline than comparator drugs. [195–198]

Dosing [135,199]

Standard dosing for adults

Initial dose of 100 mg followed by 50 mg every 12 hours, administered intravenously over approximately 30–60 minutes.

Hepatic impairment

Reduce maintenance dose (25 mg every 12 hours) for patients with severe liver impairment (Child-Pugh Class C).

Adverse reactions (non-exhaustive)

Nausea, vomiting, diarrhoea, headache

Increased alanine aminotransferase (ALT); Monitor liver function periodically.

Pancreatitis [200–203]

Coagulopathy and hypofibrinogenaemia; [204–207] Check coagulation parameters at baseline and during tigecycline therapy.

Please consult a clinical microbiologist or infectious disease physician for the use of tigecycline.