oa Southern African Journal of Epidemiology and Infection - Guideline summary : appropriate use of tigecycline
Tigecycline, the first of a new class of broad-spectrum antibiotics, the glycylcyclines, has been licensed in South Africa for the parenteral treatment of adult patients with complicated intra-abdominal (cIAI) and complicated skin and soft tissue infections (cSSTI).
This document serves as a summary of the recently published guideline on the appropriate use of tigecycline, a collaborative effort by representatives of the Association of Surgeons of South Africa, the Critical Care Society of Southern Africa, the Federation of Infectious Diseases Societies of Southern Africa, the South African Thoracic Society, and the Trauma Society of South Africa.
The guideline addressed important aspects of the new agent, including details of its metabolism and pharmacokinetics, mode of action, antibacterial spectrum, performance in key clinical trials (including data regarding its safety and tolerability), and also highlighted appropriate use of the drug. Other aspects that were considered included breakpoints for susceptibility testing, in vitro and in vivo data for activity against multi-drug resistant (MDR) pathogens, such as carbapenem-resistant Acinetobacter baumannii, Enterobacteriaceae and Stenotrophomonas maltophilia, and use in bacteraemic patients and Clostridium difficile infections (CDI).
The guideline and summary were written because of concern regarding the widespread misuse of antibiotics. The primary intention of the current publication is to facilitate, through a brief summary published in several professional journals, the heterogeneous use of antibiotics as a component of antibiotic stewardship. The emphasis is on clinical profiles that could potentially benefit from empiric or directed tigecycline therapy.
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