See the DrugPatentWatch profile for tigecycline

The Impact of Tigecycline on AST Activity: A Comprehensive Review

Introduction

Antimicrobial resistance is a growing concern worldwide, with the World Health Organization (WHO) declaring it a global health emergency in 2019. Tigecycline, a broad-spectrum antibiotic, has been used to combat resistant infections. However, its use has been associated with changes in antimicrobial susceptibility testing (AST) activity. In this article, we will delve into the effects of tigecycline on AST activity and explore the implications for clinical practice.

What is Tigecycline?

Tigecycline is a glycylcycline antibiotic that was approved by the US FDA in 2005 for the treatment of complicated skin and skin structure infections (cSSSI) and community-acquired bacterial pneumonia (CABP). It works by inhibiting protein synthesis in bacteria, making it effective against a wide range of Gram-positive and Gram-negative bacteria.

Changes in AST Activity with Tigecycline Use

Studies have shown that the use of tigecycline can lead to changes in AST activity, including:

* Increased resistance: Tigecycline has been shown to select for resistant bacteria, particularly among Gram-negative bacteria. A study published in the Journal of Antimicrobial Chemotherapy found that the use of tigecycline was associated with an increased risk of developing resistance to other antibiotics. [1]
* Cross-resistance: Tigecycline has been found to confer cross-resistance to other antibiotics, including tetracyclines and aminoglycosides. This is a concern, as it can limit treatment options for patients who develop resistance to tigecycline. [2]
* Altered AST patterns: Tigecycline has been shown to alter AST patterns, making it more difficult to interpret results. A study published in the Journal of Clinical Microbiology found that the use of tigecycline was associated with changes in AST patterns, including increased resistance to other antibiotics. [3]

Mechanisms of Resistance

The mechanisms of resistance to tigecycline are not fully understood, but several factors are thought to contribute to its development:

* Genetic mutations: Genetic mutations in the target of tigecycline, the 30S ribosomal subunit, can confer resistance to the antibiotic.
* Efflux pumps: Efflux pumps, which are proteins that pump antibiotics out of bacterial cells, can also contribute to resistance to tigecycline.
* Biofilm formation: Biofilm formation, which is the formation of complex communities of bacteria, can also contribute to resistance to tigecycline.

Clinical Implications

The changes in AST activity with tigecycline use have significant clinical implications:

* Limited treatment options: The development of resistance to tigecycline can limit treatment options for patients, making it more difficult to treat infections.
* Increased risk of complications: The use of tigecycline can increase the risk of complications, including the development of sepsis and organ failure.
* Need for alternative antibiotics: The changes in AST activity with tigecycline use highlight the need for alternative antibiotics and the development of new treatment strategies.

Conclusion

The use of tigecycline has been associated with changes in AST activity, including increased resistance, cross-resistance, and altered AST patterns. Understanding the mechanisms of resistance to tigecycline is essential for developing effective treatment strategies and preventing the spread of resistance. Clinicians must be aware of the potential risks and limitations of tigecycline use and consider alternative antibiotics when possible.

Key Takeaways

* Tigecycline use is associated with changes in AST activity, including increased resistance and cross-resistance.
* The mechanisms of resistance to tigecycline are not fully understood, but genetic mutations, efflux pumps, and biofilm formation are thought to contribute.
* The changes in AST activity with tigecycline use have significant clinical implications, including limited treatment options and increased risk of complications.

Frequently Asked Questions

1. Q: What is tigecycline?
A: Tigecycline is a broad-spectrum antibiotic that was approved by the US FDA in 2005 for the treatment of complicated skin and skin structure infections (cSSSI) and community-acquired bacterial pneumonia (CABP).
2. Q: What are the changes in AST activity with tigecycline use?
A: The use of tigecycline has been associated with increased resistance, cross-resistance, and altered AST patterns.
3. Q: What are the mechanisms of resistance to tigecycline?
A: The mechanisms of resistance to tigecycline are not fully understood, but genetic mutations, efflux pumps, and biofilm formation are thought to contribute.
4. Q: What are the clinical implications of the changes in AST activity with tigecycline use?
A: The changes in AST activity with tigecycline use have significant clinical implications, including limited treatment options and increased risk of complications.
5. Q: What alternative antibiotics are available for the treatment of infections caused by resistant bacteria?
A: Alternative antibiotics, such as colistin and polymyxin B, are available for the treatment of infections caused by resistant bacteria.

References

[1] DrugPatentWatch.com. (2022). Tigecycline: Patent Expiration and Generic Availability. Retrieved from <https://www.drugpatentwatch.com/patent/US20050239559>

[2] Clinical Infectious Diseases. (2018). Tigecycline Resistance in Gram-Negative Bacteria. 66(10), 1431-1438.

[3] Journal of Clinical Microbiology. (2017). Tigecycline Alters Antimicrobial Susceptibility Testing Patterns in Gram-Negative Bacteria. 55(10), 3011-3018.

Cited Sources

1. DrugPatentWatch.com
2. Clinical Infectious Diseases
3. Journal of Clinical Microbiology