Tigecycline

Summary

Tigecycline is a broad-spectrum antibiotic that is derived from other tetracyclines. It works by binding to and inhibiting the 30S subunit of bacterial ribosomes, thereby blocking bacterial protein synthesis. Clinically, tigecycline is used as a last-resort therapy to treat multidrug resistant organisms, like MRSA and VRE, after other antibiotics have failed. This is because of its side effects, which include severe bleeding. Another less important side effect seen in patients taking tigecycline is GI upset.

Key Points

• Tigecycline
  • Mechanism
    • Tetracycline derivative
    • Binds to 30S subunit of bacterial ribosomes
      • Inhibits bacterial protein synthesis
    • Bacteriostatic
  • Clinical Use
    • Broad-spectrum coverage
      • Gram-positive and gram-negative
    • Multidrug resistant organisms (MRSA, VRE)
      • Tigecycline is associated with higher all-cause mortality compared to other antibiotics
      • Reserved to situations where benefit outweighs the risk
    • Infections requiring deep tissue penetration
  • Adverse Effects
    • GI upset
      • nausea, vomiting
    • Bleeding
      • Hematologic abnormalities develop in a dose-dependent fashion