| Infusion technique |
• Administer the IV dose over 30–60 min (the labeled rate).
• Use a dedicated infusion set; don’t share lines or reuse tubing.
• Dilute with normal saline or 5% dextrose, not with solutions containing calcium, magnesium, iron, aluminum, or high‑chloride, high‑pH solutions that can precipitate. |
Rapid or incompatible infusions can cause drug precipitation or local irritation, and can alter serum levels. |
| Avoid drug–drug interactions |
• Do not give tigecycline concurrently (or within 2 h) with antacids or supplements containing calcium, iron, magnesium, zinc, or aluminum.
• Avoid concurrent use of strong P‑gp or CYP3A4 inducers (rifampin, carbamazepine, phenobarbital, phenytoin, St. John’s wort).
• Avoid giving it with other antibiotics that have known antagonistic activity (e.g., β‑lactams in some cases). |
These agents can chelate the drug or accelerate its clearance, leading to sub‑therapeutic levels. |
| Correct dosing & timing |
• Use the FDA‑approved dose for the infection (e.g., 100 mg IV every 12 h for complicated intra‑abdominal infections, 200 mg loading dose for cSSTIs).
• For patients with impaired renal function, adjust the interval, but do not double the dose to “compensate.”
• Ensure the 30–60 min infusion is not interrupted or shortened. |
Over‑ or under‑dosing can select for resistant mutants or leave drug levels too low to be effective. |
| Antibiotic stewardship |
• Reserve tigecycline for infections where it’s truly indicated (e.g., complicated skin/soft‑tissue infections, complicated intra‑abdominal infections, community‑acquired MRSA).
• Do not use it as a first‑line or prophylactic agent in situations where other agents are equally effective.
• Perform culture & susceptibility testing before and, if possible, after therapy. |
Reducing unnecessary exposure limits the chance that bacteria develop or select for resistance mechanisms (efflux pumps, ribosomal protection proteins, etc.). |
| Storage & handling |
• Store at 2–8 °C (refrigerated).
• Do not expose to direct light or temperatures above 30 °C.
• Use fresh vials; do not reuse or recirculate. |
Degraded drug or precipitation can reduce the amount of active drug delivered. |
| Patient factors |
• Avoid high‑dose steroids or other immunosuppressants that can blunt the host’s response.
• Monitor renal function; adjust dosing if CrCl |