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2015 ; 59
(3
): 1596-604
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Effects of tigecycline and vancomycin administration on established Clostridium
difficile infection
#MMPMID25547352
Theriot CM
; Schumacher CA
; Bassis CM
; Seekatz AM
; Young VB
Antimicrob Agents Chemother
2015[Mar]; 59
(3
): 1596-604
PMID25547352
show ga
The glycylcycline antibiotic tigecycline was approved in 2005 for the treatment
of complicated skin and soft tissue infections and complicated intra-abdominal
infections. Tigecycline is broadly active against both Gram-negative and
Gram-positive microorganisms, including Clostridium difficile. Tigecycline has a
low MIC against C. difficile in vitro and thus may represent an alternate
treatment for C. difficile infection (CDI). To assess the use of tigecycline for
treatment of established CDI, 5- to 8-week-old C57BL/6 mice were colonized with
C. difficile strain 630. After C. difficile colonization was established, mice (n
= 10 per group) were treated with either a 5-day course of tigecycline (6.25
mg/kg every 12 h subcutaneously) or a 5-day course of vancomycin (0.4 mg/ml in
drinking water) and compared to infected, untreated control mice. Mice were
evaluated for clinical signs of CDI throughout treatment and at 1 week
posttreatment to assess potential for disease development. Immediately following
a treatment course, C. difficile was not detectable in the feces of
vancomycin-treated mice but remained detectable in feces from tigecycline-treated
and untreated control mice. Toxin activity and histopathological inflammation and
edema were observed in the ceca and colons of untreated mice; tigecycline- and
vancomycin-treated mice did not show such changes directly after treatment. One
week after the conclusion of either antibiotic treatment, C. difficile load,
toxin activity, and histopathology scores increased in the cecum and colon,
indicating that C. difficile-associated disease occurred. In vitro growth studies
confirmed that subinhibitory concentrations of tigecycline were able to suppress
toxin activity and spore formation of C. difficile, whereas vancomycin did not.
Taken together, these data show how tigecycline is able to alter C. difficile
pathogenesis in a mouse model of CDI.