Potential role of tigecycline in the treatment of community-acquired bacterial pneumonia

Mary L Townsend^1,2, Melanie W Pound^1,3, Richard H Drew^1,4
1Campbell University College of Pharmacy and Health Sciences, Buies Creek, NC, USA; ²Durham Veterans Affairs Medical Center, Durham, NC, USA; ³New Hanover Regional Medical Center, Wilmington, NC, USA; ⁴Duke University School of Medicine and Duke University Medical Center, Durham, NC, USA

Abstract: Tigecycline is a member of the glycylcycline class of antimicrobials, which is structurally similar to the tetracycline class. It demonstrates potent in vitro activity against causative pathogens that are most frequently isolated in patients with community-acquired bacterial pneumonia (CABP), including (but not limited to) Streptococcus pneumoniae (both penicillin-sensitive and -resistant strains), Haemophilus influenzae and Moraxella catarrhalis (including β-lactamase-producing strains), Klebsiella pneumoniae, and ‘atypical organisms’ (namely Chlamydophila pneumoniae, Mycoplasma pneumoniae, and Legionella pneumophila). Comparative randomized clinical trials to date performed in hospitalized patients receiving tigecycline 100 mg intravenous (IV) × 1 and then 50 mg IV twice daily thereafter have demonstrated efficacy and safety comparable to the comparator agent. Major adverse effects were primarily gastrointestinal in nature. Tigecycline represents a parenteral monotherapy option in hospitalized patients with CABP (especially in patients unable to receive respiratory fluoroquinolones). However, alternate and/or additional therapies should be considered in patients with more severe forms of CABP in light of recent data of increased mortality in patients receiving tigecycline for other types of severe infection.

Keywords: tigecycline, glycylcycline, community-acquired pneumonia