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2017 ; 10
(ä): 401-417
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Efficacy of intravenous tigecycline in patients with Acinetobacter complex
infections: results from 14 Phase III and Phase IV clinical trials
#MMPMID29138583
Tucker H
; Wible M
; Gandhi A
; Quintana A
Infect Drug Resist
2017[]; 10
(ä): 401-417
PMID29138583
show ga
BACKGROUND: Acinetobacter infections, especially multidrug-resistant (MDR)
Acinetobacter infections, are a global health problem. This study aimed to
describe clinical outcomes in patients with confirmed Acinetobacter spp. isolates
who were treated with tigecycline in randomized clinical trials. MATERIALS AND
METHODS: Data from 14 multinational, randomized (open-label or double-blind), and
active-controlled (except one) Phase III and IV studies were analyzed using
descriptive statistics. RESULTS: A total of 174 microbiologically evaluable
patients with Acinetobacter spp. infections (including MDR infections) were
identified, and 95 received tigecycline to treat community-acquired pneumonia
(CAP), diabetic foot infections (DFIs), hospital-acquired pneumonia (HAP),
complicated intra-abdominal infections (cIAIs), infections with resistant
pathogens (RPs), or complicated skin and skin-structure infections. The rate of
cure of tigecycline for most indications was 70%-80%, with the highest (88.2%) in
cIAIs. The rate of cure of the comparators was generally higher than tigecycline,
but within each indication the 95% CIs for clinical cure for each treatment group
overlapped. For most Acinetobacter isolates, the minimum inhibitory concentration
of tigecycline was 0.12-2 ?g/mL, with seven at 4 ?g/mL and one at 8 ?g/mL. The
cure rate by tigecycline was 50% (95% CI 12.5%-87.5% in CAP) to 88.2% (95% CI
66.2%-97.1% in cIAIs) for all Acinetobacter, and 72.7% (95% CI 54.5%-93.2% in
HAP) to 100% (95% CI 25%-100.0% in cIAIs) for MDR Acinetobacter. For the
comparators, it was 83.8% (95% CI 62.8%-95.9% in HAP) to 100% (95% CI 75%-100% in
cIAIs and 25%-100.0% in RPs) and 88% (95% CI 66%-97% in HAP) to 100% (95% CI
25%-100% in cIAIs and 75%-100% in DFIs), respectively. CONCLUSION: These findings
suggest that with appropriate monitoring, tigecycline may be a useful
consideration for Acinetobacter infections alone or in combination with other
anti-infective agents when other therapies are not suitable.