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What bacterial infections does tigecycline treat? Tigecycline is FDA-approved for complicated skin and skin-structure infections, complicated intra-abdominal infections, and community-acquired bacterial pneumonia. It works against many Gram-positive, Gram-negative, and anaerobic bacteria, including some multidrug-resistant strains. [1] How does tigecycline work against resistant organisms? The drug binds the 30S ribosomal subunit and blocks protein synthesis. Because its structure includes a glycylamido side chain, it evades common tetracycline-resistance pumps, giving activity against methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and many extended-spectrum β-lactamase producers. [2] What is a real-world case example? A 68-year-old man with diabetes developed a polymicrobial intra-abdominal infection after bowel surgery. Cultures grew ESBL-producing Klebsiella pneumoniae and Enterococcus faecium. After failing carbapenem therapy, clinicians switched to intravenous tigecycline 100 mg once, then 50 mg every 12 hours for 10 days. The patient defervesced within 48 hours and completed a full recovery. [3] When is tigecycline usually avoided? Because it achieves low serum concentrations, it is not used for bloodstream infections or hospital-acquired pneumonia. It also carries an FDA boxed warning for increased all-cause mortality in certain severe infections. [1] What alternatives exist if tigecycline cannot be used? For similar resistant Gram-negative coverage, clinicians may turn to newer β-lactam/β-lactamase-inhibitor combinations such as ceftazidime-avibactam or meropenem-vaborbactam, depending on local resistance patterns. [4] When does the patent on tigecycline expire? The composition-of-matter patent listed for Tygacil expired in 2015; generic versions are now available in the United States. [5] Sources [1] https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/021821s025lbl.pdf [2] https://pubmed.ncbi.nlm.nih.gov/15784848/ [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4187782/ [4] https://www.idsociety.org/practice-guideline/antimicrobial-resistant-infections/ [5] https://www.drugpatentwatch.com/drug/tygacil
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