Clinical Effectiveness of a Once-daily Regimen of Tigecycline Compared to the Standard Regimen

Clinical Effectiveness of a Once-daily Regimen of Tigecycline Compared to the Standard Regimen in Critically Ill Patients

To compare the clinical response (efficacy) and the safety of the tigecycline once daily regimen versus the standard regimen (twice daily regimen). Clinical response was categorized as a cure, failure of treatment, or indeterminate outcome.24 Treatment success (Cure): defined as resolution of signs/symptoms of infection, microbiological cure (negative cultures after tigecycline use), improvement of infection markers (leukocytic count, C reactive protein, and procalcitonin).

Treatment failure: defined as persistence of signs/symptoms of infection despite antimicrobial therapy, deterioration of infection markers (leukocytic count, C reactive protein, and Procalcitonin).

Indeterminate response: subjects who do not have an outcome determination for reasons unrelated to the study drug or infection (e.g., loss to follow-up, withdrawal of consent, etc.) Safety will be assessed by the incidence of adverse events especially which leads to treatment discontinuation.36

Inclusion Criteria:

• Age 18 years or older.
• Both males and females.
• Diagnosis of infection has been established and tigecycline use is indicated (intra-abdominal, community-acquired pneumonia, skin Infections) or based on genetic testing and microbiological cultures (MDR Acinetobacter, MDR Stenotrophomonas, MDR Enterobacteriaceae, etc.)

Exclusion Criteria:

• Pregnancy and lactation.
• Bloodstream infections (BSI) and urinary tract infections (UTIs).
• Refusal of attending staff or patient, or family.
• Contraindications to tigecycline, such as hypersensitivity and allergy.
• Patients receiving ≤ 1 day of tigecycline (insufficient length of therapy).
• Patients who have acute physiology and chronic health evaluation (APACHE 2) score of more than 35 (high risk of mortality).
• Do not resuscitate/do not intubate (DNR, DNI) patients.