• Garyphallia Poulakou, Flora V Kontopidou, Elisabeth Paramythiotou, Maria Kompoti, Maria Katsiari, Efstratios Mainas, Chara Nicolaou, Dimitrios Yphantis, Anastasia Antoniadou, Eleftheria Trikka-Graphakos, Zoi Roussou, Phyllis Clouva, Nina Maguina, Kyriaki Kanellakopoulou, Apostolos Armaganidis, and Helen Giamarellou.
• 4th Department of Internal Medicine, Athens University School of Medicine, ATTIKON University General Hospital of Athens, Athens, Greece.
• J. Infect. 2009 Apr 1; 58 (4): 273-84.

ObjectiveThis observational retrospective study aims to present early experience with tigecycline (TIG) in the treatment of infections due to multi-drug resistant (MDR) microorganisms.MethodsAdult patients included, received TIG for >5 days either as monotherapy (M group) or as presumed active monotherapy (PAM group). In the PAM group, all co-administered antimicrobial(s) were resistant in vitro against the targeted pathogen(s) or had been clinically and microbiologically failing after >or=5 days of therapy despite in vitro susceptibility.ResultsForty-five patients (35 in ICU) were treated for 28 Acinetobacter baumannii and 23 Klebsiella pneumoniae infections [21 ventilator-associated and healthcare-acquired pneumonia (VAP/HCAP), 10 bloodstream infections (BSI) and 14 surgical infections (SI)]. Successful overall clinical outcome was 80%, i.e. 81.8% in M group, 78.3% in PAM group, 90.5% in VAP/HCAP, 80% in BSI, 64.3% in SI and 85% in the cases with septic shock. Superinfections from Enterobacteriaceae inherently resistant to tigecycline occurred in 31.8% of M and 13% of PAM group (p<0.001).ConclusionTIG represents a promising option in infections from MDR pathogens, however, further clinical experience is required.

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