[Off label uses of tigecycline]

Abstract

Introduction: Tigecycline is a relatively new antibiotic that have very limited valid indications. When no other alternative is available, this drug is widely used off label with promising results. The objective of this study is to summarize the different off label uses of tigecycline so that we can decide when and how to prescribe it in the absence of guidelines.

Material and methods: This study a revue of the literature collecting all the articles concerning the off label uses of tigecycline.

Results: Tigecycline was widely prescribed, off label, to treat infections with controversial results. Randomised clinical trials were conducted to evaluate its use to treat pneumonia. The results for this indication have a respectable level of evidence. For the other indications, the data collected was insufficient to support tigecycline prescription. In fact, different protocols were used which makes it hard to evaluate the efficacy and to conclude to the best treatment regimen. A tendency to prescribe high doses of the molecule was noted in different studies. When prescribed off label, tigecycline prescriptions were associated with a higher mortality and incidence of side effects.

Conclusion: The tigecycline remains a valid option for the treatment of infections dues to multi-resistant bacteria especially when other alternatives are scarce or in cases of renal failure.

Keywords: Hors-AMM; Indication; Off-label use; Pharmacocinétique; Pharmacodynamic activity; Pharmacodynamique; Pharmacokinetic characteristics; Therapeutic indication; Tigecycline; Tigécycline.