Tigecycline therapy for multidrug-resistant bacteria: is it the right choice for pediatric patients

Abstract

Introduction: The incidence of infections caused by multidrug-resistant pathogens is increasing worldwide, resulting in significant morbidity and mortality. Tigecycline has become a good option because it has a broad spectrum of antibacterial activity. This study aimed to reveal the clinical, microbiological, and laboratory outcomes of hospitalized children treated with tigecycline.

Methodology: We retrospectively collected the medical records of the hospitalized pediatric patients treated with tigecycline from April 1, 2018, to Apr 30, 2023, at Ege University Children's Hospital. Demographic features and clinical and laboratory findings were evaluated to determine the efficacy and safety of tigecycline therapy.

Results: Sixty-seven patients (65.7% male) with a median age of 6 years (2.5 months-17.5 years) were included. There was an underlying condition in 83.5% of the patients, and 55.2% were immunosuppressed. The most common infections were; lower respiratory tract infections (29.8%), intra-abdominal infections (20.9%), bloodstream infections (17.9%), and soft tissue infections (13.4%), respectively. Acinetobacter spp. (28.4%) was the most isolated microorganism, followed by Klebsiella spp. (19.4%) and Enterococcus spp. (14.9%). Tigecycline was used as a targeted treatment in 76.1% of the patients and was often used as a combination therapy (80.6%) with a median duration of 12 days (range, 2-60 days). Clinical response was achieved in 65.6% of patients, microbiologic response in 62.6%, and treatment failure in 34.3%. No major adverse events were noted during the therapy.

Conclusions: Tigecycline, which was mostly preferred in combination therapy, had high clinical response and microbiologic eradication rates, but these rates varied according to infection sites and microorganism species.