Updated: 2/26/2019

Tigecycline

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Snapshot
  • A 60-year-old man presents to the emergency room for a swollen, red hand. He reports sustaining a fall 2 days ago onto the affected hand. Since then, he has had fevers, chills, and increased redness spreading from the site of trauma. He has a past medical history of recurrent MRSA infections, intravenous drug use, and diabetes mellitus. A search into his medical record shows that he has been treated for vancomycin-resistant MRSA in the past year. A newer generation tetracycline derivative has been used successfully in the past to treat his soft tissue infections. He is empirically started on this drug after blood cultures are drawn. (Cellulitis)
Introduction
  • Drugs
    • tigecycline
      • a glycylcycline, a tetracycline derivative
      • intravenous (IV) only
  • Mechanism of action
    • binds to bacterial ribosomal 30S subunit, which inhibits protein synthesis
    • bacteriostatic
    • mainly eliminated via stools
  • Clinical use
    • broad-spectrum antibiotic with activity against gram-negative, anaerobic, and gram-positive organisms
      • MRSA
      • VRE
    • skin and soft-tissue infections
    • intra-abdominal infections
    • no activity against Pseudomonas
  • Adverse effects
    • gastrointestinal upset
 

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