Tigecycline

Restricted
Restricted

C. diff Risk

Medium

Oral Bioavailability

NA

Approximate Cost

Dosing

Requires Infectious Disease consultation for use OR completion of the Restricted Antimicrobial order form for approved indications

100 mg IV load on day 1 then 50 mg IV every 12 hr

Severe Impairment - Child Pugh C
100 mg load on day 1 then 25 mg IV every 24 hr

General Information

Acceptable Uses

Documented Allergy to Beta-lactams/vancomycin and/or resistant to other antimicrobials and one of the following criteria met:

  • Treatment of Intra-abdominal infection

  • Treatment of skin and soft tissue infection

  • Treatment of polymicrobial infections (not Psuedomonas or Proteus)

Unacceptable Uses

  • Pneumonia, as unacceptably high failure rates have been reported (see black box warning)

  • Bacteremia, as documented safety concerns exist.

  • Infections caused by Pseudomonas and Proteus species

Common Usage

Reserved for highly resistant infections or when significant allergies restrict other options and when there is documented susceptibility.

Associated with more treatment failures than alternatives and excess mortality - Black Box Warning.

Drug Monitoring

Lab

  • periodic LFTs

Clinical

  • GI effects

Adverse Effects

  • Avoid or use with caution in patients with tetracycline reactions.

  • GI side effects very prominent with significant nausea and vomiting.

  • Tetracycline related adverse events: photosensitivity, acute pancreatitis.

  • Rash, abnormal liver enzymes.

Major Interactions

Oral contraceptives less effective.

Additional Information

Requires Infectious Disease consultation.

Documented safety concerns in bacteremia especially.

Pharmacology

Antimicrobial class: Tetracycline derivative

Pregnancy category: D

Average serum half life: 42 hours

Biliary penetration: Therapeutic

Lung penetration: Therapeutic