What is the role of tigecycline in the treatment of community-acquired pneumonia (CAP)?

Updated: Aug 29, 2019
  • Author: Fariba M Donovan, MD, PhD; Chief Editor: Thomas E Herchline, MD  more...
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Answer

Answer

Since the publication of the 2007 IDSA/American Thoracic Society (ATS) guidelines for the management of CAP in adults, 2 intravenous antimicrobials have been approved by the US Food and Drug Administration (FDA) for the treatment of CAP: tigecycline and ceftaroline fosamil.

Use of tigecycline in CAP

Tigecycline was approved by the FDA in 2009 for adults with CAP caused by S pneumoniae (penicillin-susceptible isolates), including cases with concurrent bacteremia, H influenza (beta-lactamase-negative isolates), and Legionella pneumophila. In a study conducted to evaluate the efficacy of tigecycline versus levofloxacin in hospitalized patients with CAP, tigecycline achieved cure rates similar to those of levofloxacin in hospitalized patients with CAP. For patients with risk factors, tigecycline provided generally favorable clinical outcomes. [3]

Data from various sources, including PubMed, the European Medicines Agency (EMEA), and the FDA were appraised. Tigecycline was found to be noninferior compared with levofloxacin for the treatment of patients with bacterial CAP requiring hospitalization. [4]

Although tigecycline is indicated for CAP, data from clinical trials suggest a high incidence of adverse events, particularly gastrointestinal adverse effects, which may limit its use. [5]

Dosing for tigecycline is as follows:

  • Tigecycline 100 mg IV loading dose, then 50 mg IV q12h for 7-14 d

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