Tigecycline use in the outpatient parenteral antibiotic therapy setting

Paul Ingram, M.D.M. Rawlins, Ronan Murray, J.A. Roberts, Laurens Manning

    Research output: Contribution to journalArticle

    Abstract

    © 2016, Springer-Verlag Berlin Heidelberg.In the context of globally increasing antimicrobial resistance, tigecycline appears to be a useful therapeutic option. The need for prolonged courses for complex infections has prompted consideration of its use via outpatient parenteral antibiotic therapy (OPAT) programmes, although clinical outcomes when used in this setting remain unknown. We retrospectively reviewed the patient characteristics and outcomes of 11 patients who received tigecycline, most commonly delivered as 100 mg once daily, via OPAT at three tertiary Australian hospitals. Rates of co-morbidity and prior antibiotic use were high. Patients had a wide range of infections including bone and/or joint (n = 5), intra-abdominal (n = 3), lower respiratory tract (n = 2) and parapharyngeal abscess (n = 1). Mycobacterial species (n = 5) were the most frequent pathogen, and multi-resistant organisms were common (n = 4). The median OPAT duration was 14 days (IQR 6–30). Nausea was encountered in 45 % of cases. At completion of OPAT, 1 patient (9 %) was cured, 2 (18 %) had improved and 8 (73 %) failed therapy. Failure occurred due to either progression or non-response of infection (n = 4), re-admission (n = 3), premature cessation of tigecycline due to nausea (n = 3) or death (n = 1). Whilst OPAT delivery of tigecycline is a therapeutic option, when used as second-line therapy for complex, often multi-resistant infections in patients with multiple comorbidities, high rates of clinical failure, readmissions and adverse effects, especially nausea, should be anticipated.
    Original languageEnglish
    Pages (from-to)1673-1677
    Number of pages5
    JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
    Volume35
    Issue number10
    DOIs
    Publication statusPublished - Oct 2016

    Fingerprint

    Outpatients
    Anti-Bacterial Agents
    Nausea
    Therapeutics
    Infection
    tigecycline
    Berlin
    Tertiary Care Centers
    Respiratory System
    Abscess
    Comorbidity
    Joints
    Morbidity
    Bone and Bones

    Cite this

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    abstract = "{\circledC} 2016, Springer-Verlag Berlin Heidelberg.In the context of globally increasing antimicrobial resistance, tigecycline appears to be a useful therapeutic option. The need for prolonged courses for complex infections has prompted consideration of its use via outpatient parenteral antibiotic therapy (OPAT) programmes, although clinical outcomes when used in this setting remain unknown. We retrospectively reviewed the patient characteristics and outcomes of 11 patients who received tigecycline, most commonly delivered as 100 mg once daily, via OPAT at three tertiary Australian hospitals. Rates of co-morbidity and prior antibiotic use were high. Patients had a wide range of infections including bone and/or joint (n = 5), intra-abdominal (n = 3), lower respiratory tract (n = 2) and parapharyngeal abscess (n = 1). Mycobacterial species (n = 5) were the most frequent pathogen, and multi-resistant organisms were common (n = 4). The median OPAT duration was 14 days (IQR 6–30). Nausea was encountered in 45 {\%} of cases. At completion of OPAT, 1 patient (9 {\%}) was cured, 2 (18 {\%}) had improved and 8 (73 {\%}) failed therapy. Failure occurred due to either progression or non-response of infection (n = 4), re-admission (n = 3), premature cessation of tigecycline due to nausea (n = 3) or death (n = 1). Whilst OPAT delivery of tigecycline is a therapeutic option, when used as second-line therapy for complex, often multi-resistant infections in patients with multiple comorbidities, high rates of clinical failure, readmissions and adverse effects, especially nausea, should be anticipated.",
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    Tigecycline use in the outpatient parenteral antibiotic therapy setting. / Ingram, Paul; Rawlins, M.D.M.; Murray, Ronan; Roberts, J.A.; Manning, Laurens.

    In: European Journal of Clinical Microbiology and Infectious Diseases, Vol. 35, No. 10, 10.2016, p. 1673-1677.

    Research output: Contribution to journalArticle

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    AU - Ingram, Paul

    AU - Rawlins, M.D.M.

    AU - Murray, Ronan

    AU - Roberts, J.A.

    AU - Manning, Laurens

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