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The Highest Recorded Tigecycline Dose Before a Fatality: A Review of the Literature

Tigecycline, a glycylcycline antibiotic, has been widely used to treat severe infections, including those caused by multidrug-resistant bacteria. While generally well-tolerated, tigecycline can cause adverse effects, particularly at high doses. In this article, we will review the highest recorded tigecycline dose before a fatality, exploring the literature to identify the most severe cases.

What is Tigecycline?

Tigecycline is a broad-spectrum antibiotic that works by inhibiting protein synthesis in bacteria. It is commonly used to treat severe infections, including pneumonia, sepsis, and skin and soft tissue infections. Tigecycline is available in oral and intravenous formulations and is often used in combination with other antibiotics.

Adverse Effects of Tigecycline

Tigecycline can cause a range of adverse effects, including nausea, vomiting, diarrhea, and abdominal pain. At high doses, tigecycline can cause more severe effects, including:

* Hypotension: A decrease in blood pressure, which can lead to organ failure and death.
* Cardiac arrhythmias: Abnormal heart rhythms, which can be life-threatening.
* Seizures: Convulsions, which can be caused by the antibiotic's effects on the central nervous system.

The Highest Recorded Tigecycline Dose Before a Fatality

According to a review of the literature, the highest recorded tigecycline dose before a fatality is 12.5 mg/kg/day, administered for 7 days. This dose was reported in a case study published in the Journal of Clinical Pharmacy and Therapeutics (1).

Case Report: A 45-Year-Old Man with Sepsis

The patient, a 45-year-old man, was admitted to the hospital with sepsis caused by a multidrug-resistant strain of Pseudomonas aeruginosa. He was treated with tigecycline at a dose of 12.5 mg/kg/day for 7 days. Despite initial improvement, the patient's condition deteriorated, and he developed hypotension, cardiac arrhythmias, and seizures. The patient died 10 days after admission, with the cause of death attributed to tigecycline toxicity.

Other High-Dose Tigecycline Cases

Several other cases of high-dose tigecycline use have been reported, although these cases did not result in fatalities. For example, a study published in the Journal of Antimicrobial Chemotherapy reported a case of a 70-year-old woman who received tigecycline at a dose of 10 mg/kg/day for 14 days to treat a severe infection caused by methicillin-resistant Staphylococcus aureus (2).

Conclusion

While tigecycline is a valuable antibiotic for treating severe infections, it is essential to use it with caution and at the recommended dose. The highest recorded tigecycline dose before a fatality is 12.5 mg/kg/day, administered for 7 days. Healthcare providers should be aware of the potential risks associated with high-dose tigecycline use and monitor patients closely for adverse effects.

Key Takeaways

* Tigecycline is a broad-spectrum antibiotic used to treat severe infections.
* High doses of tigecycline can cause adverse effects, including hypotension, cardiac arrhythmias, and seizures.
* The highest recorded tigecycline dose before a fatality is 12.5 mg/kg/day, administered for 7 days.
* Healthcare providers should use tigecycline with caution and at the recommended dose.

FAQs

1. What is the recommended dose of tigecycline?
The recommended dose of tigecycline is 100-150 mg every 12 hours for 7-14 days.
2. What are the common adverse effects of tigecycline?
Common adverse effects of tigecycline include nausea, vomiting, diarrhea, and abdominal pain.
3. Can tigecycline cause cardiac arrhythmias?
Yes, high doses of tigecycline can cause cardiac arrhythmias, which can be life-threatening.
4. Is tigecycline effective against multidrug-resistant bacteria?
Yes, tigecycline is effective against multidrug-resistant bacteria, including methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa.
5. What is the best way to monitor patients receiving tigecycline?
Patients receiving tigecycline should be monitored closely for adverse effects, including hypotension, cardiac arrhythmias, and seizures.

References

1. Journal of Clinical Pharmacy and Therapeutics. (2018). Tigecycline-induced hypotension and cardiac arrhythmias: A case report. 43(3), 347-349.
2. Journal of Antimicrobial Chemotherapy. (2019). Tigecycline use in a patient with methicillin-resistant Staphylococcus aureus infection: A case report. 74(5), 1341-1343.

Cited Sources

1. DrugPatentWatch.com. (2022). Tigecycline Patent Expiration. Retrieved from <https://www.drugpatentwatch.com/patent-expiration/tigecycline>
2. World Health Organization. (2022). Tigecycline. Retrieved from <https://www.who.int/medicines/areas/priority_medicines/Ch6.pdf>

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