Updated: 2/26/2019


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  • 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)
  • 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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