What Infections Does Tigecycline Target?
Tigecycline, a glycylcycline antibiotic, mainly treats complicated skin and skin structure infections (cSSSI), complicated intra-abdominal infections (cIAI), and community-acquired bacterial pneumonia (CABP) caused by susceptible bacteria.[1]
It works against multidrug-resistant Gram-positive bacteria like methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus species (VRE), Gram-negative bacteria including Acinetobacter baumannii and extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae, and anaerobes.1
How Does Tigecycline Work Against These Pathogens?
Tigecycline inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit, evading common resistance mechanisms like efflux pumps that affect other tetracyclines. This broad-spectrum activity covers pathogens in polymicrobial infections common in hospital settings.2
What Specific Pathogens Are Covered?
- Skin infections: MRSA, Enterococcus faecalis (vancomycin-susceptible), Escherichia coli, Klebsiella pneumoniae.
- Abdominal infections: Bacteroides fragilis, Eikenella corrodens, Citrobacter species.
- Pneumonia: Streptococcus pneumoniae, Haemophilus influenzae, Legionella pneumophila.[1]
Not approved for urinary tract infections due to low renal excretion or bloodstream infections as primary therapy.2
When Is Tigecycline Used Off-Label?
Clinicians sometimes use it for severe infections like hospital-acquired pneumonia, diabetic foot infections, or Clostridium difficile-associated diarrhea, though evidence varies and FDA limits primary use to approved indications.2
What Are Common Side Effects and Risks?
Patients report nausea (26%), vomiting (18%), and diarrhea (13%). It carries a black box warning for increased mortality risk in certain infections and fetal harm in pregnancy. Avoid in children under 8 or those with known hypersensitivity.1
Alternatives to Tigecycline
| Drug | Key Targets | Notes |
|------|-------------|-------|
| Vancomycin | MRSA, VRE | IV only; nephrotoxic risk |
| Linezolid | MRSA, VRE, pneumonia | Oral/IV; bone marrow suppression |
| Meropenem | Gram-negatives, anaerobes | Broad; resistance concerns |
| Daptomycin | Skin infections, bacteremia | Inactivated by surfactant (not pneumonia) |
Tigecycline suits resistant cases where others fail, but higher doses may be needed for some pathogens.2
[1]: https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/021821s021lbl.pdf (Tygacil FDA Label)