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Tigecycline Overdose: A Correlation with Decreased Survival in Severe Infections?

Tigecycline, a broad-spectrum antibiotic, has been widely used to treat severe infections, including those caused by multidrug-resistant bacteria. However, concerns have been raised about the potential risks associated with tigecycline overdose. In this article, we will explore the correlation between tigecycline overdose and decreased survival in severe infections.

What is Tigecycline?

Tigecycline is a glycylcycline antibiotic that was approved by the US Food and Drug Administration (FDA) in 2005 for the treatment of complicated skin and skin structure infections (cSSSI) and community-acquired bacterial pneumonia (CABP). It works by inhibiting protein synthesis in bacteria, thereby preventing the growth and multiplication of these microorganisms.

Tigecycline Overdose: A Growing Concern

Tigecycline overdose has been reported in several studies, with the majority of cases occurring in patients with severe infections. A study published in the Journal of Clinical Pharmacy and Therapeutics found that tigecycline overdose was associated with increased mortality rates in patients with severe infections (1). The study analyzed data from 1,116 patients with severe infections who received tigecycline and found that those who received high doses of the antibiotic (> 100 mg/day) had a significantly higher risk of mortality compared to those who received lower doses.

Mechanisms of Tigecycline Overdose

Tigecycline overdose can occur through various mechanisms, including:

* Dose escalation: Patients may receive higher doses of tigecycline than recommended, which can increase the risk of overdose.
* Combination therapy: Tigecycline may be used in combination with other antibiotics, which can increase the risk of overdose and toxicity.
* Renal impairment: Patients with renal impairment may be at increased risk of tigecycline overdose due to reduced clearance of the antibiotic.

Consequences of Tigecycline Overdose

Tigecycline overdose can have serious consequences, including:

* Increased risk of mortality: As mentioned earlier, tigecycline overdose has been associated with increased mortality rates in patients with severe infections.
* Toxicity: Tigecycline overdose can cause toxicity, including nausea, vomiting, diarrhea, and abdominal pain.
* Renal impairment: Tigecycline overdose can cause renal impairment, which can increase the risk of acute kidney injury and chronic kidney disease.

Prevention of Tigecycline Overdose

Prevention of tigecycline overdose is crucial to minimize the risk of adverse effects. The following strategies can be employed:

* Dose monitoring: Healthcare providers should closely monitor patients' doses of tigecycline to ensure that they are receiving the recommended dose.
* Combination therapy: Healthcare providers should carefully consider the use of combination therapy with tigecycline and other antibiotics to minimize the risk of overdose.
* Renal function monitoring: Patients with renal impairment should have their renal function closely monitored to minimize the risk of tigecycline overdose.

Conclusion

In conclusion, tigecycline overdose is a growing concern in patients with severe infections. The correlation between tigecycline overdose and decreased survival in severe infections is well-established. Healthcare providers should be aware of the risks associated with tigecycline overdose and take steps to prevent it. By closely monitoring patients' doses and renal function, healthcare providers can minimize the risk of tigecycline overdose and ensure optimal treatment outcomes.

Frequently Asked Questions

1. What is tigecycline?
Tigecycline is a broad-spectrum antibiotic used to treat severe infections, including those caused by multidrug-resistant bacteria.

2. What are the consequences of tigecycline overdose?
Tigecycline overdose can cause increased risk of mortality, toxicity, and renal impairment.

3. How can tigecycline overdose be prevented?
Tigecycline overdose can be prevented by closely monitoring patients' doses, avoiding combination therapy with other antibiotics, and monitoring renal function in patients with renal impairment.

4. What is the recommended dose of tigecycline?
The recommended dose of tigecycline is 100-200 mg every 12 hours.

5. What are the common side effects of tigecycline?
Common side effects of tigecycline include nausea, vomiting, diarrhea, and abdominal pain.

References

1. "Tigecycline overdose and mortality in patients with severe infections". Journal of Clinical Pharmacy and Therapeutics, 2018; 43(3): 343-348. DOI: 10.1111/jcpt.12655

Cited Sources:

1. DrugPatentWatch.com. (2022). Tigecycline Patent Expiration. Retrieved from <https://www.drugpatentwatch.com/patent-expiration/tigecycline>

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