Yonsei Med J.  2012 Sep;53(5):974-984.

Clinical Outcomes of Tigecycline in the Treatment of Multidrug-Resistant Acinetobacter baumannii Infection

• Shin JA
• Chang YS
• Kim HJ
• Kim SK
• Chang J
• Ahn CM
• Byun MK

Abstract

PURPOSE
Acinetobacter baumannii (A. baumannii) has emerged as a major cause of nosocomial pneumonia and sepsis in seriously ill patients. Multidrug-resistant A. baumannii (MDRAB) is increasing in frequency, and the management of it's infections is consequently difficult. Therefore, tigecycline is considered to be the drug of choice for MDRAB treatment. The aim of our study was to evaluate the microbiological eradication and clinical effectiveness of tigecycline against MDRAB in seriously ill patients, including patients with ventilator-associated pneumonia (VAP).
MATERIALS AND METHODS
We conducted a retrospective study including patients with A. baumannii infections who were treated with tigecycline between April 1, 2009 and March 31, 2010. We treated 27 patients with tigecycline for MDRAB infections.
RESULTS
The mean age of patients was 66.2 years, and 20 (74.1%) patients were male. The median length of stay at hospital was 74.6 days. MDRAB was eradicated from the site of infection in 23 cases (85.2%), however, only 17 cases (63.0%) showed positive clinical responses. Overall, an in-hospital mortality rate of 51.9% was observed, and 4 cases of death were attributable to sepsis. The combination therapy showed better clinical and microbial success rates than the monotherapy without significant difference.
CONCLUSION
We observed the relatively low clinical success rate although the microbial eradication rate was high, probably due to superinfections in VAP and bacteremia. We suggest that clinicians should limit tigecycline monotherapy for MDRAB infection in critically ill patients, until large controlled clinical trials should be conducted.

Keyword

Acinetobacter baumannii; bacteremia; multidrug resistance; tigecycline; ventilator-associated pneumonia

MeSH Terms

Acinetobacter baumannii*
Acinetobacter*
Bacteremia
Critical Illness
Drug Resistance, Multiple
Hospital Mortality
Humans
Length of Stay
Male
Pneumonia
Pneumonia, Ventilator-Associated
Retrospective Studies
Sepsis
Superinfection
Treatment Outcome

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