Influence of age on the clinical efficacy of tigecycline in severely ill patients. (September 2019)

• Record Type: Journal Article
• Authors: Bassetti, Matteo; Guirao, Xavier; Montravers, Philippe; Rossolini, Gian Maria; Sánchez García, Miguel; Sganga, Gabriele; Eckmann, Christian
• Is Part Of: Journal of global antimicrobial resistance. Volume 18(2019)
• Page Start: 199
• Page End: 206
• Publication Date: 2019-09
• Subjects: Elderly -- Glycylcycline -- Tetracycline -- Tigecycline -- Complicated skin and soft-tissue infection -- Complicated intra-abdominal infection; Drug resistance -- Periodicals; Drug resistance -- Periodicals; Drug resistance; Periodicals; 616.9041
• DOI: 10.1016/j.jgar.2019.03.018
• Languages: English
• ISSNs: 2213-7165

Abstract

Highlights: Patients aged <65 years showed the best response to tigecycline treatment versus those aged ≥65 years. Patients with cSSTI and cIAI aged >65 years showed a good response to tigecycline treatment. Favourable outcomes were shown in severely ill elderly patients receiving tigecycline. Abstract: Objectives: The aim of this study was to define the relationship between age and response to tigecycline among patients treated for complicated skin and soft-tissue infections (cSSTIs) and complicated intra-abdominal infections (cIAIs). Methods: Pooled data derived from five European observational studies on the use of tigecycline (July 2006–October 2011), either as monotherapy or in combination with other antibiotics, for the treatment of cSSTI or cIAI were used in the analysis. Results: The total population ( N = 1782 patients) was divided into three age categories: <65 years (804 patients); 65–80 years (836 patients) and >80 years (139 patients) (data unknown/missing for 3 patients). The overall mean Acute Physiology and Chronic Health Evaluation (APACHE) II score for patients with cSSTI and cIAI was 15.0 ± 7.9 and 16.9 ± 7.6, respectively, and the overall mean Sequential Organ Failure Assessment (SOFA) score was 5.8 ± 3.9 and 7.0 ± 4.2, respectively. Overall, patients with cSSTI and cIAI in the three age groups showed a good response to tigecycline treatment (76.2–80.0% and 69.2–81.1%, respectively) with patients aged ≤80 years showing higher response rates. Patients with cIAI appeared to be at greater risk for all types of adverse events compared with those with cSSTI, particularly in the older age groups. Conclusion: In these real-life studies, tigecycline, either alone or in combination, achieved favourable clinical response rates in all age categories of patients with cSSTIs and cIAIs with a high severity of illness.