See the DrugPatentWatch profile for tigecycline

Tigecycline is an antibiotic used to treat various bacterial infections, including complicated skin and intra-abdominal infections, community-acquired pneumonia, and complicated urinary tract infections [1]. The development of tigecycline resistance is influenced by several factors.

1. Overuse and Misuse: Overuse and misuse of tigecycline can contribute to the development of resistance [1]. This includes using tigecycline to treat infections caused by organisms for which it is not the first-line treatment or using it in suboptimal doses or durations.

2. Cross-Resistance: Tigecycline is a member of the tetracycline class of antibiotics. Bacteria that have developed resistance to other tetracyclines may also exhibit cross-resistance to tigecycline [1]. This is because these bacteria may have efflux pumps or ribosomal protection proteins that confer resistance to multiple tetracyclines, including tigecycline.

3. Efflux Pumps: Some bacteria have efflux pumps that can pump tigecycline out of the cell, reducing its intracellular concentration and leading to resistance [2]. These efflux pumps can be constitutively expressed or induced by the presence of tigecycline or other antibiotics.

4. Ribosomal Protection Proteins: Some bacteria produce ribosomal protection proteins that bind to the ribosome and prevent tigecycline from binding, leading to resistance [2]. These proteins can be constitutively expressed or induced by the presence of tigecycline or other antibiotics.

5. Mutations: Mutations in bacterial genes can also lead to tigecycline resistance [2]. For example, mutations in the 16S rRNA gene can alter the binding site for tigecycline, reducing its effectiveness.

6. Horizontal Gene Transfer: Resistance to tigecycline can also be acquired through horizontal gene transfer, such as via plasmids or transposons [2]. These mobile genetic elements can carry genes that encode efflux pumps or ribosomal protection proteins, allowing resistance to spread between bacteria.

In conclusion, the development of tigecycline resistance is influenced by several factors, including overuse and misuse, cross-resistance, efflux pumps, ribosomal protection proteins, mutations, and horizontal gene transfer. Understanding these factors can help in the development of strategies to prevent or delay the development of tigecycline resistance.

Sources:
[1] DrugPatentWatch.com. (n.d.). Tigecycline. Retrieved from https://www.drugpatentwatch.com/drugs/tigecycline
[2] He, Y., Wu, L., Zhang, L., Wang, J., & Zhang, Y. (2015). Tigecycline resistance and its molecular mechanisms. Journal of Global Antimicrobial Resistance, 2(1), 31-36. doi:10.1016/j.jgar.2015.01.002