Tigecycline 약물 사용 평가
Drug Use Evaluation of Tigecycline
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Tigecycline is a wide-spectrum intravenous glycylcycline and is generally active against most gram-positive and gram-negative bacteria, including anaerobes, atypical bacteria and many species of multidrug-resistant bacteria. This agent presents a predictable pharmacokinetic profile and minimal drug interaction. It is generally well tolerated, with nausea being the most common adverse event. However, currently FDA warned about increased risk for death in patients who received tigecycline for serious infections. Therefore, this study was performed to evaluate the use of tigecycline and its efficacy. We retrospectively analyzed medical records of patients who received tigecycline at Chonbuk National University Hospital, from January 1, 2013 to December 31, 2014. As a result, the justification of appropriate use showed a rate of 69 cases (86.2%). Tigecycline was properly used according to the criteria in 51-80 cases (81.2-100%), while culture and sensitivity were infrequently performed before the initial dose. The mean duration of administration was 18±15 days. Complications in tigecycline use were usually GI problems including nausea (12 cases), vomiting (6 cases) and diarrhea (2 cases); the treatment efficacy response rate was 57.5%. This study showed that tigecycline was being used for appropriate reasons, but not being well monitored. Inappropriate use of tigecycline can lead to cause multidrug-resistant bacteria and unexpected side effects. So, a cautious attitude is required in its use.
Abstract
Tigecycline is a wide-spectrum intravenous glycylcycline and is generally active against most gram-positive and gram-negative bacteria, including anaerobes, atypical bacteria and many species of multidrug-resistant bacteria. This agent presents a predictable pharmacokinetic profile and minimal drug interaction. It is generally well tolerated, with nausea being the most common adverse event. However, currently FDA warned about increased risk for death in patients who received tigecycline for serious infections. Therefore, this study was performed to evaluate the use of tigecycline and its efficacy. We retrospectively analyzed medical records of patients who received tigecycline at Chonbuk National University Hospital, from January 1, 2013 to December 31, 2014. As a result, the justification of appropriate use showed a rate of 69 cases (86.2%). Tigecycline was properly used according to the criteria in 51-80 cases (81.2-100%), while culture and sensitivity were infrequently performed before the initial dose. The mean duration of administration was 18±15 days. Complications in tigecycline use were usually GI problems including nausea (12 cases), vomiting (6 cases) and diarrhea (2 cases); the treatment efficacy response rate was 57.5%. This study showed that tigecycline was being used for appropriate reasons, but not being well monitored. Inappropriate use of tigecycline can lead to cause multidrug-resistant bacteria and unexpected side effects. So, a cautious attitude is required in its use.
참고문헌 (21)
- Package insert, "Tygacil (tigecycline) for injection" (2005), Wyeth Pharmaceuticals
- Livermore D. M, "Tigecycline : What is it, and where should it be used?", J Antimicrob Chemother, 56(4), pp.611~614 (2005)
- Doan T. L., "Tigecycline : a glycylcycline antimicobial agent", Clin Ther, 28(8), pp.1079~1106 (2006)
- Hoban D. J., "In vitro activity of tigecycline against 6792 Gram-negative and Gram-positive clinical isolates from the global Tigecycline Evaluation and Surveillance Trial (TEST Program, 2004)", Diagn Microbiol Infect Dis, 52(3), pp.215~227 (2005)
- Draghi D. C., "Baseline in vitro activity of tigecycline among key bacterial pathogens exhibiting multidrug resistance", Chemotherapy, 54(2), pp.91~100 (2008)
- Garrison M. W., "In vitro activity of tigecycline against quinoloneresistant Steptococcus pneumoniae, methicillin-resistance Staphylococcus aureus and vancomycin-resistance enterococci", Int J Antimicrob Agents, 29(2), pp.191~196 (2007)
- Leclerc T., "Treatment of a septic shock due to multiresistant Acinetobacter baumannii with tigecycline in combination", Ann Fr Anesth Reanim, 26(12), pp.1056~1058 (2007)
- Vasilev K., "A Phase 3, open-label, non-comparative study of tigecycline in the treatment of patients with selected serious infections due to resistant Gram-negative organisms including Enterobacter species, Acinetobacter baumannii and Klebsidella pneumoniae", J Antimicrob Chemother, 62(Suppl 1), pp.i29~i40 (2008)
- "Tigecycline Injection" (2010)[URL]
- Rossi F., "Overview of tigecycline and its role in the era of antibiotic resistance", Beaz J Infect Dis, 10(3), pp.203~216 (2006)
- Chuang Y. C., "Efficacy and safety of tigecycline monotherapy compared with vancomycin-aztreonam in the treatment of complicated skin and skin structure infections in patients from India and Taiwan", J Microbiol Immunol Infect, 44(2), pp.116~124 (2011)
- Swoboda S., "Septic shock due to vancomycin-resistant enterococci infection. Tigecycline monotherapy", Anaesthesist, 56(2), pp.169~174 (2007)
- US FDA, "FDA drug safety communication:increased risk of death with Tygacil (Tigecycline) compared to other antibiotics used to treat similar infections", ~ (2013)
- Freire A. T., "Comparison of tigecycline with imipenem", cilastatin for the treatment of hospitalacquired pneumonia, 2010, pp.68(2), 140~151
- Burkhardt O., "Tigecycline possibly underdosed for the treatment of pneumonia : a pharmacokinetic viewpoint", Int J Antimicrob Agents, 34(1), pp.101~102 (2009)
- Bhattacharya M, "Tigecycline", J Postgrad Med, 55(1), pp.65~68 (2009)
- Eckmann C., "Prospective, non-interventional, multi-centre trial of tigecycline in the treatment of severely ill patients with complicated infections : new insights into clinical results and treatment practice", Chemotherapy, 57(4), pp.275~284 (2011)
- 이미숙, "새로운 항생제의 개발", 대한내과학회지, 77(1), pp.35~51 (2009), 대한내과학회
- Yahav D., "Efficacy and safety of tigecycline : a systematic review and meta-analysis", J Antimicrob Chemother, 66(9), pp.1963~1971 (2011)
- Prasad P., "Excess deaths associated with tigecycline after approval based on noninferiority trials", Clin Infect Dis, 54(12), pp.1699~1709 (2012)
- 김형숙, "의료기관의 감염관리 약사 활동 - 항생제 관리팀 약사", J Kor Soc Health-Syst Pharm, 33(1), pp.61~65 (2016)