PMID- 31567945
OWN - NLM
STAT- MEDLINE
DCOM- 20191010
LR  - 20231104
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 98
IP  - 38
DP  - 2019 Sep
TI  - Efficacy and safety of high-dose tigecycline for the treatment of infectious 
      diseases: A meta-analysis.
PG  - e17091
LID - 10.1097/MD.0000000000017091 [doi]
LID - e17091
AB  - BACKGROUND: High-dose (HD) tigecycline regimen is increasingly used in infectious 
      diseases, however its efficacy and safety versus low-dose (LD) is still unclear. 
      METHODS: A systematic review and meta-analysis was performed; PubMed, Embase, 
      Cochrane Library, ScienceDirect, Web of Science, clinicalTrials.gov, Wanfang, 
      VIP, and China National Knowledge Infrastructure (CNKI), were searched using 
      terms "tigecycline" AND "dose" up to October 31, 2018. Eligible studies were 
      randomized trials or cohort studies comparing mortality, clinical response, 
      microbiological eradication and safety of different tigecycline dose regimens for 
      any bacterial infection. The primary outcome was mortality, and the secondary 
      outcomes were clinical response rate, microbiological eradiation rate and adverse 
      events (AEs). Meta-analysis was done with random-effects model, with risk ratios 
      (RR) and 95% confidence intervals (CI) calculated for all outcomes. RESULTS: Of 
      951 publications retrieved, 17 studies (n = 1041) were pooled in our 
      meta-analysis. The primary outcome was available in 11 studies, and the RR for 
      mortality was 0.67 (95% CI 0.53-0.84, P < .001). Clinical response (RR 1.46, 95% 
      CI 1.30-1.65, P < .001) and microbiological eradication rate (RR 1.61, 95% CI 
      1.35-1.93, P < .001) were both higher in HD than in LD tigecycline regimen. 
      However, non-Chinese study subgroup presented no statistical significance between 
      HD and LD regimen, RR for mortality, clinical response and microbiological 
      eradication were 0.79 (95% CI 0.56-1.14, P = .21), 1.35 (95% CI 0.96-1.92, 
      P = .26), 1.00 (95% CI 0.22-4.43, P = 1.00), respectively. AEs did not differ 
      between HD and LD tigecycline (RR 1.00, 95% CI 0.80-1.26, P = .97). CONCLUSION: 
      HD tigecycline regimen reduced mortality meanwhile improved clinical efficacy and 
      should be considered in serious infections caused by multidrug-resistant and 
      extensively drug-resistant (MDR/XDR) bacteria.
FAU - Gong, Jinhong
AU  - Gong J
AD  - Department of Pharmacy, The Affiliated Changzhou No. 2 People's Hospital of 
      Nanjing Medical University, Changzhou.
AD  - Department of Pharmaceutics, College of Pharmaceutical Sciences, Soochow 
      University, Suzhou.
FAU - Su, Dan
AU  - Su D
AD  - Department of Pharmacy, The Affiliated Changzhou No. 2 People's Hospital of 
      Nanjing Medical University, Changzhou.
FAU - Shang, Jingjing
AU  - Shang J
AD  - Department of Pharmacy, The Affiliated Changzhou No. 2 People's Hospital of 
      Nanjing Medical University, Changzhou.
FAU - Yu, Hai
AU  - Yu H
AD  - Department of Neurology, Huashan Hospital, Fudan University, Shanghai.
FAU - Du, Guantao
AU  - Du G
AD  - Institution of Drug Clinical Trial.
FAU - Lin, Ying
AU  - Lin Y
AD  - Department of Pharmacy, The Affiliated Changzhou No. 2 People's Hospital of 
      Nanjing Medical University, Changzhou.
FAU - Sun, Zhiqiang
AU  - Sun Z
AD  - Department of Radiotherapy, The Affiliated Changzhou NO.2 People's Hospital of 
      Nanjing Medical University, Changzhou, China.
FAU - Liu, Guangjun
AU  - Liu G
AD  - Department of Pharmacy, The Affiliated Changzhou No. 2 People's Hospital of 
      Nanjing Medical University, Changzhou.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Anti-Bacterial Agents)
RN  - 70JE2N95KR (Tigecycline)
SB  - IM
MH  - Anti-Bacterial Agents/administration & dosage/*therapeutic use
MH  - Dose-Response Relationship, Drug
MH  - Humans
MH  - Pneumonia, Bacterial/*drug therapy
MH  - Tigecycline/administration & dosage/*therapeutic use
MH  - Treatment Outcome
PMC - PMC6756684
COIS- All authors declared that there was no conflict of interest.
EDAT- 2019/10/01 06:00
MHDA- 2019/10/11 06:00
PMCR- 2019/09/20
CRDT- 2019/10/01 06:00
PHST- 2019/10/01 06:00 [entrez]
PHST- 2019/10/01 06:00 [pubmed]
PHST- 2019/10/11 06:00 [medline]
PHST- 2019/09/20 00:00 [pmc-release]
AID - 00005792-201909200-00015 [pii]
AID - MD-D-19-01423 [pii]
AID - 10.1097/MD.0000000000017091 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2019 Sep;98(38):e17091. doi: 10.1097/MD.0000000000017091.