Healthcare

Tigecycline is the first clinically-available drug in a new class of antibiotics called the glycyclines, marketed as Tygacil from Wyeth, which were approved by the U.S. Food and Drug Administration on June 2005 for treatment of complicated intra-abdominal infections, complicated skin and skin structure infections, and community acquired pneumonia.

Common adverse effect of this drug are diarrhea, nausea, and vomiting that usually occur in the first 2 days of therapy.

While this antibiotic had similar effectiveness to other comparator antibiotics, however, the results were not completely consistent and could be bias.

Therefore, due to this, Dr. Rui Wang and colleagues from the PLA General Hospital, Beijing, People’s Republic of China, conducted meta-analysis for the benefits and risk of antibiotic tigecycline compared with other antibiotics.

By using data pooled from 80 quality randomized controlled trials, the researchers analyzed clinical success such as complete solution or substantial improvement of signs and symptoms of infection and no further antimicrobial therapy or surgical intervention for infection, and microbiological success such as eraducation based on the clinical outcomes when post-treatment cultures were not performed.

Overall, they found that although tigecycline had similar effective to other comparator antibiotics for skin and skin structure infections, complicated intra-abdominal infections, and community-acquired pneumonia, however, tigecycline increased incidence of all adverse events included diarrhea, nausea, and vomiting, including fever, headache, infection, abdominal pain, chills, pain, and particular involving to digestive system.

Therefore, the researchers said that the data highlight the the clinicians need to monitor for signs and symptoms of digestive problems in patient treated with tigecycline.

While the U.S. FDA warned of an increased risk of death associated with the use of tigecycline compared with other antibiotics announced on September 1, 2010 — “FDA Drug Safety Communication: Increased risk of death with Tygacil (tigecycline) compared to other antibiotics used to treat similar infection” — which were the most evidence of death risk for patients with hospital-acquired pneumonia (especially ventilator-associated pneumonia), including in patients with complicated skin and skin structure infections, complicated intra-abdominal infections and diabetic foot infection, the current meta-analysis also showed numerically but not significantly higher mortality rates with tigecycline, both for all-cause mortality and “possible drug related” mortality.

Finally, Dr. Wan and colleagues encourages clinicians to “carefully consider” the benefits and risks of tigecycline before using it.