Antimicrobials
Tigecycline (Tygacil®)

Tigecycline (Tygacil®)

Restricted

Medium
N/A

Dosing

General Information

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.

Restriction: Restricted to ID expert or designee

Criteria for Use: Complicated intra-abdominal infections due to susceptible multi-drug resistant (MDR) gram-negative organisms but resistant to other broad spectrum antibiotics

Unacceptable Uses:

  • Bacteremia (low serum concentrations)
  • UTIs (low urinary concentrations)
  • Severely sick patients (e.g. in ICU on pressure support)

Advisory:

  • Because of a potential for increased mortality, tigecycline should be reserved for use when alternative treatment options are not suitable
  • Does not cover against Pseudomonas aeruginosa, Proteus sp., Providencia and Morganella
  • Possibility of cross-sensitivity in tetracycline allergic patients cannot be ruled out

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 pancreatiti.

Rash, abnormal liver enzymes.

Oral contraceptives less effective.

Requires Infectious Disease consultation.

Documented safety concerns in bacteremia especially.

Antimicrobial class: Tetracycline derivative

Pregnancy category: D

Average serum half life: 42 hours

Lung penetration: Therapeutic

Biliary penetration: Therapeutic