Clinical Medicine Reviews in Therapeutics

This paper reviews the antimicrobial profile and available clinical data for the first member of the glycylcycline class, tigecycline. Emerging multi-drug resistance among gram-positive and gram-negative pathogens continues to limit the antibiotic armamentarium. Tigecycline, a derivative of minocycline, may provide a therapeutic option in select patients, given its broad spectrum of activity, including multi-drug resistant (MDR) strains. A search of Medline and EmBase of articles through April 2010 and references of select citations was conducted. Several randomized controlled studies have resulted in the approval of tigecycline in the treatment of skin and skin structure infections, complicated intra-abdominal infections, and community acquired pneumonia. Several other studies and single-center observations have demonstrated select efficacy in specific populations including ventilator-associated pneumonia, bacteremia, and other infections secondary to MDR pathogens. These data, along with pharmacokinetic and safety issues, are reviewed to offer insight into appropriate patient selection for tigecycline therapy.