Medicine & USMLE

Tigecycline

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Antibiotics / Antiparasitics
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  2. Penicillinase-Sensitive vs. Penicillinase-Resistant Penicillins
  3. Anti-Pseudomonal Penicillins
  4. Cephalosporins Overview
  5. 1st Generation Cephalosporins
  6. 2nd Generation Cephalosporins
  7. 3rd Generation Cephalosporins
  8. 4th Generation Cephalosporins
  9. 5th Generation Cephalosporins
  10. Carbapenems
  11. Monobactams (Aztreonam)
  12. Vancomycin
  13. Aminoglycosides
  14. Tetracyclines
  15. Tigecycline
  16. Chloramphenicol
  17. Clindamycin
  18. Linezolid
  19. Macrolides
  20. Polymyxins
  21. Sulfonamides
  22. Dapsone
  23. Trimethoprim
  24. Fluoroquinolones
  25. Daptomycin
  26. Metronidazole
  27. Rifamycins (Rifampin, Rifabutin)
  28. Isoniazid
  29. Pyrazinamide
  30. Ethambutol
  31. Chloroquine

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