Drug reference
Tigecycline is a glycylcycline antibacterial structurally related to the tetracyclines. Tigecycline is active against Gram-positive and Gram-negative bacteria, including tetracycline-resistant organisms, and some anaerobes. It is also active against meticillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, but Pseudomonas aeruginosa and many strains of Proteus spp are resistant to tigecycline.
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Complicated skin and soft tissue infections (when other antibiotics are not suitable) | Complicated intra- abdominal infections (when other antibiotics are not suitable) ▶BY INTRAVENOUS INFUSION ▶Adult: Initially 100 mg, followed by 50 mg every 12 hours for 5–14 days
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Diabetic foot infections
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Cholestasis
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Contra-indicated in patients hypersensitive to tetracyclines.
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→Appendix 1: tigecycline
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▶Common or very common Abscess. appetite decreased. diarrhoea. dizziness. gastrointestinal discomfort. headache. healing impaired. hyperbilirubinaemia. hypoglycaemia. hypoproteinaemia. increased risk of infection. nausea. sepsis. skin reactions. vomiting ▶Uncommon Hepatic disorders. pancreatitis. thrombocytopenia. thrombophlebitis ▶Frequency not known Acidosis. azotaemia. hyperphosphataemia. hypofibrinogenaemia. idiopathic intracranial hypertension. photosensitivity reaction. pseudomembranous enterocolitis. severe cutaneous adverse reactions (SCARs). tooth discolouration SIDE-EFFECTS, FURTHER INFORMATION Side-effects similar to those of the tetracyclines can potentially occur.
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Tetracyclines should not be given to pregnant women; effects on skeletal development have been documented in the first trimester in animal studies. Administration during the second or third trimester may cause discoloration of the child’s teeth, and maternal hepatotoxicity has been reported with large parenteral doses.
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Manufacturer advises avoid—present in milk in animal studies.
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Manufacturer advises caution in severe impairment. Dose adjustments Manufacturer advises dose reduction to 25 mg every 12 hours following the loading dose in severe impairment.
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For intravenous infusion (Tygacil ®), give intermittently in Glucose 5% or Sodium Chloride 0.9%. Reconstitute each vial with 5.3 mL infusion fluid to produce a 10 mg/mL solution; dilute requisite dose in 100 mL infusion fluid; give over 30–60 minutes.
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There can be variation in the licensing of different medicines containing the same drug. Powder for solution for infusion ▶Tigecycline (Non-proprietary) Tigecycline 50 mg Tigecycline 50mg powder for solution for infusion vials | 10 vial P £290.79 (Hospital only) ▶Tygacil (Pfizer Ltd) Tigecycline 50 mg Tygacil 50mg powder for solution for infusion vials | 10 vial P £323.10 (Hospital only) ANTIBACTERIALS › OTHER
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Driving and skilled tasks Manufacturer advises patients and carers should be cautioned on the effects on driving and performance of skilled tasks—increased risk of dizziness.
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Initially 100 mg, followed by 50 mg every
First-line fragment. Read the complete Indications and Dose section above.
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