Efficacy of tigecycline for the treatment of complicated intra-abdominal infections in real-life clinical practice from five European observational studies

Objectives: Tigecycline is a broad-spectrum antibiotic approved for the treatment of complicated intra-abdom-inal infections (cIAIs). The efficacy of tigecycline when administered as monotherapy or in combination withother antibacterials in the treatment of cIAIs in routine clinical practice is described.Patients and methods: Individual patient-level data were pooled from five European observational studies (July2006 to October 2011).Results: A total of 785 cIAI patients who received tigecycline were included (mean age 63.1+14.0 years). Ofthese, 56.6% were in intensive care units, 65.6% acquired their infection in hospital, 88.1% had at least onecomorbidity and 65.7% had secondary peritonitis. The mean Acute Physiology and Chronic Health Evaluation(APACHE) II and Sequential Organ Failure Assessment (SOFA) scores at the beginning of treatment were16.9+7.6 (n¼614) and 7.0+4.2 (n¼108), respectively, indicating high disease severity. Escherichia coli(41.8%), Enterococcus faecium (40.1%) and Enterococcus faecalis (21.1%) were the most frequently isolatedpathogens; 49.1% of infections were polymicrobial and 17.5% were due to resistant pathogens. Overall,54.8% (n¼430) received tigecycline as monotherapy and 45.2% (n¼355) as combination therapy for amean duration of 10.6 days. Clinical response rates at the end of treatment were 77.4% for all patients(567/733), 80.6% for patients who received tigecycline as monotherapy (329/408), 75.2% for patients witha nosocomial infection (354/471), 75.8% for patients with an APACHE II score .15 (250/330) and 54.2%(32/59) for patients with a SOFA score ≥7.Conclusions: In these real-life studies, tigecycline, alone and in combination, achieved favourable clinical re-sponse rates in patients with cIAI with a high severity of illness.Keywords: broad-spectrum antibacterial therapy, generalized peritonitis, non-interventional studies, glycylcycline antibiotics