Indications of a new antibiotic in clinical practice: results of the tigecycline initial use registry
AUTOR(ES)
Curcio, Daniel, Fernández, Francisco, Cané, Alejandro, Barcelona, Laura, Stamboulian, Daniel
FONTE
Brazilian Journal of Infectious Diseases
DATA DE PUBLICAÇÃO
2008-06
RESUMO
Tigecycline is the first of a new class of antibiotics named glycylcyclines and it was approved for the treatment of complicated intra-abdominal infections and complicated skin and skin structure infections. Notwithstanding this, tigecycline's pharmacological and microbiological profile which includes multidrug-resistant pathogens encourages physicians' use of the drug in other infections. We analyzed, during the first months after its launch, the tigecycline prescriptions for 113 patients in 12 institutions. Twenty-five patients (22%) received tigecycline for approved indications, and 88 (78%) for "off label" indications (56% with scientific support and 22% with limited or without any scientific support). The most frequent "off label" use was ventilator associated pneumonia (VAP) (63 patients). The etiology of infections was established in 105 patients (93%). MDR-Acinetobacter spp. was the microorganism most frequently isolated (50% of the cases). Overall, attending physicians reported clinical success in 86 of the 113 patients (76%). Our study shows that the "off label" use of tigecycline is frequent, especially in VAP. due to MDR-Acinetobacter spp., where the therapeutic options are limited (eg: colistin). Physicians must evaluate the benefits/risks of using this antibiotic for indications that lack rigorous scientific support.
Documentos Relacionados
- Organizational and Physician Perspectives about Facilitating Handheld Computer Use in Clinical Practice: Results of a Cross-Site Qualitative Study
- Extent of underdiagnosis of familial hypercholesterolaemia in routine practice: prospective registry study
- Nephrology in practice: a new series
- Galactomannan use in clinical practice: providing free testing is not the full answer
- Indications, technique, and clinical use of ambulatory 24-hour esophageal motility monitoring in a surgical practice.