PMID- 30235740
OWN - NLM
STAT- MEDLINE
DCOM- 20181003
LR  - 20221005
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 38
DP  - 2018 Sep
TI  - Adverse events of high-dose tigecycline in the treatment of ventilator-associated 
      pneumonia due to multidrug-resistant pathogens.
PG  - e12467
LID - 10.1097/MD.0000000000012467 [doi]
LID - e12467
AB  - The off-label uses of tigecycline (TGC) to treat ventilator-associated pneumonia 
      (VAP) have aroused worldwide concerns. The efficacy about TGC has been recently 
      reported. However, the adverse events (AEs) remain controversial. Our study aims 
      to analyze the safety of the high-dose (HD) regimens in the treatment of VAP due 
      to multidrug-resistant (MDR) pathogens.The clinical data of 134 patients who were 
      diagnosed with VAP from January 2013 to December 2015 in the NeuroScience Care 
      Unit (NCU) were analyzed retrospectively. The incidence and the occurrence time 
      of AEs, 28-day mortality, and the factors of clinical effectiveness were 
      explored.A total of 54 patients received the standard dose group (SD), 69 in the 
      HD, and 11 in the nonstandard HD group (NHD). Acinetobacter baumannii were the 
      main pathogenic bacteria. There was no statistic difference in the incidence of 
      AEs and the 28-day mortality among the 3 groups (P > .05). Total bilirubin (TBIL) 
      increased significantly after SD of TGC treatment (P = .004). Liver dysfunction 
      occurred the latest (10.83 +/- 7.08), not in the duration of HD group 
      (9.63 +/- 3.92), whereas in the SD group (13.00 +/- 7.57) and NHD group 
      (12.64 +/- 3.70). Patients with septic shock, MODS, and higher APACHE II score were 
      of high risk in mortality. The HD group was associated with higher clinical 
      effective rate and bacteria clearance rate.HD TGC was relatively safe and 
      tolerable in ICU patients. The risk of side effects was related to the TGC 
      duration, although not increased as the dosage rose. Full course of the HD 
      regimen was associated with better outcomes for the treatment of VAP patients, 
      especially for the MDR gram-negative bacilli infection. Inappropriate 
      antimicrobial treatment might lead to clinical treatment failure.
FAU - Chen, Zihan
AU  - Chen Z
AD  - Department of NeuroScience Care Unit, The Second Affiliated Hospital of Zhejiang 
      University School of Medicine, Hangzhou, China.
FAU - Shi, Xiaoyan
AU  - Shi X
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Anti-Bacterial Agents)
RN  - 70JE2N95KR (Tigecycline)
RN  - FYY3R43WGO (Minocycline)
SB  - IM
MH  - Acinetobacter baumannii/drug effects
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Bacterial Agents/administration & dosage/*adverse effects
MH  - *Drug Resistance, Multiple, Bacterial
MH  - Drug-Related Side Effects and Adverse Reactions/*microbiology
MH  - Female
MH  - Gram-Negative Bacteria/drug effects
MH  - Gram-Negative Bacterial Infections/drug therapy/microbiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Minocycline/administration & dosage/adverse effects/*analogs & derivatives
MH  - Pneumonia, Ventilator-Associated/*drug therapy/microbiology
MH  - Tigecycline
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC6160260
EDAT- 2018/09/22 06:00
MHDA- 2018/10/04 06:00
PMCR- 2018/09/21
CRDT- 2018/09/22 06:00
PHST- 2018/09/22 06:00 [entrez]
PHST- 2018/09/22 06:00 [pubmed]
PHST- 2018/10/04 06:00 [medline]
PHST- 2018/09/21 00:00 [pmc-release]
AID - 00005792-201809210-00088 [pii]
AID - MD-D-18-00934 [pii]
AID - 10.1097/MD.0000000000012467 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2018 Sep;97(38):e12467. doi: 10.1097/MD.0000000000012467.