Tigecycline

Class: Glycylcycline antibiotic (tetracycline derivative)

Mechanism of Action: Inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit, preventing incorporation of amino acid residues into elongating peptide chains. Active against a broad spectrum of Gram-positive, Gram-negative (excluding Pseudomonas), and anaerobic bacteria.

Indications

• Complicated skin and soft tissue infections
• Complicated intra-abdominal infections
• Community-acquired bacterial pneumonia
• Multidrug-resistant infections (MRSA, VRE)

Dosage

• Adults: Loading dose 100 mg IV, followed by 50 mg IV every 12 hours
• Severe infections: Dose adjustment may be required based on renal and hepatic function
• Pediatrics: Safety and efficacy not established for children under 8 years

Maximum Dose

100 mg loading dose, then 50 mg every 12 hours (adjusted for hepatic impairment)

Major Side Effects

• Nausea and vomiting (most common)
• Diarrhea
• Headache
• Increased liver enzymes
• Pancreatitis (rare)
• Photosensitivity

Contraindications

• Hypersensitivity to tigecycline or tetracycline derivatives
• Use with caution in severe hepatic impairment

Compatible Fluids

• 0.9% Sodium Chloride
• 5% Dextrose

Route of Administration

• Intravenous (IV) infusion only

Type of Administration

• IV: Infuse over 30–60 minutes

Special Precautions

• Use cautiously in patients with hepatic impairment
• Monitor liver function tests during prolonged therapy
• May reduce effectiveness of oral contraceptives
• May cause teeth and bone discoloration in children <8 years (avoid)
• Monitor for signs of superinfection (e.g., C. difficile colitis)