Use of tigecycline in pediatric clinical practice

Expert Rev Anti Infect Ther. 2017 Jun;15(6):605-612. doi: 10.1080/14787210.2017.1318064. Epub 2017 Apr 17.

Abstract

Tigecycline, a derivative of minocycline, is an extended-spectrum antimicrobial agent. It has a restricted approval field in children and the experience of its adoption in clinical practice is reserved for cases of challenging infections. The aim of this review was to summarize evidence regarding the use of tigecycline in infants and children, focusing on the drug's clinical efficacy data and tolerability profile. Areas covered: We have conducted a literature search of the Cochrane Library, EMBASE, and MEDLINE databases, from their inception through 5 January 2017, using the following terms: tigecycline, newborn, infant, child, pediatrics, adolescent, human, clinical trial, and case report. Articles were excluded if they were redundant or not pertinent. Bibliographies of all relevant articles were also evaluated. Seventeen publications were included: 1 pharmacokinetic study, 16 case reports. In the selected publications, the patients' mean age was 4.45 years, 38.7% of children was <3 years old and favorable clinical response was achieved in 74.2% of cases. Expert commentary: Tigecycline may be a considerable option in life-threatening infections in pediatric patients. Its administration is well tolerated and has demonstrated a good clinical response in nonbacteremic patients. However, the available clinical records are limited and more studies are needed.

Keywords: Tygecycline; case reports; children; clinical trial; infants.

Publication types

  • Review

MeSH terms

  • Acinetobacter Infections / drug therapy*
  • Acinetobacter Infections / microbiology
  • Acinetobacter Infections / pathology
  • Acinetobacter baumannii / drug effects
  • Acinetobacter baumannii / growth & development
  • Acinetobacter baumannii / pathogenicity
  • Adolescent
  • Anti-Bacterial Agents / therapeutic use*
  • Child
  • Child, Preschool
  • Enterobacteriaceae / drug effects
  • Enterobacteriaceae / growth & development
  • Enterobacteriaceae / pathogenicity
  • Enterobacteriaceae Infections / drug therapy*
  • Enterobacteriaceae Infections / microbiology
  • Enterobacteriaceae Infections / pathology
  • Humans
  • Infant
  • Infant, Newborn
  • Methicillin-Resistant Staphylococcus aureus / drug effects
  • Methicillin-Resistant Staphylococcus aureus / growth & development
  • Methicillin-Resistant Staphylococcus aureus / pathogenicity
  • Microbial Sensitivity Tests
  • Minocycline / analogs & derivatives*
  • Minocycline / therapeutic use
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / microbiology
  • Staphylococcal Infections / pathology
  • Tigecycline
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Tigecycline
  • Minocycline