Tigecycline
General
- Type: Glycylcycline (Tetracyclines)
- Dosage Forms: IV
- Common Trade Names: Tygacil
Adult Dosing
Intra-Abdominal Infections
- 50mg IV q12h x5-14 days
- Start: 100mg IV x1
Skin Infections, complicated
- 50mg IV q12h x5-14 days
- Start: 100mg IV x1
Pneumonia, Community acquired
- 50mg IV q12h for at least 5 days
- Start 100mg IV x1
- May D/C after 5 days if afebrile 48-72h
Pediatric Dosing
Intra-abdominal Infections
- 8-11yo
- 1.2 mg/kg IV q12h
- Max: 50 mg/12h
- 12-17 yo
- 50mg IV 112h
Skin Infections, complicated
- 8-11yo
- 1.2 mg/kg IV q12h
- Max: 50 mg/12h
- 12-17 yo
- 50mg IV 112h
Pneumonia, Community Acquired
- 8-11yo
- 1.2 mg/kg IV q12h
- Max: 50 mg/12h
- 12-17 yo
- 50mg IV 112h
Special Populations
- Drug rating in pregnancy: D
- Lactation risk category: Possibly Unsafe; consider alternatives
- Renal Dosing
- Adult: No adjustment
- Pediatric: No adjustment
- Hepatic Dosing
- Adult:
- Child-Pugh Class C: Decrease maintenance dose 50%
- Pediatric:
- Not defined, but may be required. See adult dosing.
- Adult:
Contraindications
- Allergy to class/drug
- Pregnancy
- Age <8 years
- Hospital-acquired pneumonia
- Diabetic foot infection
- Caution:
- Child bearing potential
- Hepatic impairment
Adverse Reactions
Serious
- Tooth discoloration children <8 years old
- Photosensitivity
- Hypersensitivity reaction
- Skin reaction
- Vasculitis
- Pericarditis
- Autoimmune hepatitis
- Hepatotoxicity
- Nephrotoxicity
- Esophagitis/ulcer
- Pancreatitis
- Thrombocytopenia
- Neutropenia
- Hemolytic anemia
- Pseudotumor cerebri
- Bulging fontanelles
- Jarisch-Herxheimer reaction
- Fetal harm
Common
- Headache
- Nausea
- Dyspepsia
- Arthralgia
- Diarrhea
- Rash
- Dysmenorrhea
- Photosensitivity
- Vulvovaginal candidiasis
- Skin discoloration
- Elevated BUN
Pharmacology
- Half-life: Unknown
- Metabolism: Minimal
- Excretion: Bile/feces - 59%; Urine 33%
- Mechanism of Action: Bacteriostatic
Antibiotic Sensitivities[1]
Key
- S susceptible/sensitive (usually)
- I intermediate (variably susceptible/resistant)
- R resistant (or not effective clinically)
- S+ synergistic with cell wall antibiotics
- U sensitive for UTI only (non systemic infection)
- X1 no data
- X2 active in vitro, but not used clinically
- X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
- X4 active in vitro, but not clinically effective for strep pneumonia
See Also
References
- Sanford Guide to Antimicrobial Therapy 2014
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