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Dose optimization based on pharmacokinetic/pharmacodynamic target of tigecycline.

B. Leng,Genquan Yan,Cuicui Wang,Chengwu Shen,Wen Zhang,Wei Wang

Published 2021 in Journal of Global Antimicrobial Resistance

ABSTRACT

Tigecycline, a new glycylcycline antibiotic, has a promising efficacy against a broad spectrum of microbials. It is widely prescribed for various infections, with most prescriptions being considered for off-label use. However, only a few years after its approval by the US Food and Drug Administration, tigecycline is suspected of increasing all-cause mortality. Some clinicians have suggested such unfavorable outcomes correlate with inadequate drug exposure at the infective sites. A drug's pharmacokinetic/pharmacodynamic (PK/PD) profile plays an important role in predicting its antibiotic effect, which is determined as the ratio of area under the concentration curve (AUC) to minimum inhibitory concentration (MIC) for tigecycline. In this study, PK/PD targets based on infection sites, microbial isolates, and patient populations are discussed. Generally, a higher dosage of tigecycline for treatment of serious infections has been recommended in previous reports. However, the latest finding of tigecycline's atypical protein binding property requires consideration when recommending further use. In addition, combination therapy with other antibiotics provides another option by potentially decreasing the MIC values of multiple drug-resistant (MDR) bacteria.

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