Friday, June 24, 2011

Regarding Tigecycline in MDR Klebsiella and MDR Acinetobacter baumannii

Q: 72 year old NHR female is admitted to ICU with Urosepsis. Record shows previous cultures growing MDR Klebsiella resistant to most antibiotics. Pharmacy suggested Tigecycline?

Answer: Tigecycline is one of the very few antibiotics which are highly active against multidrug-resistant (MDR) Klebsiella pneumoniae and MDR Acinetobacter baumannii (MDR KP/AB) but may require high dosing for maximal therapeutic effectiveness. In such cases use an initial dose of 200 mg IV followed by 100 mg IV daily. If patient does not respond to this dose further higher dose can be use with initial dose of 400 mg IV followed by 200 mg IV daily.

Caution: Tigecycline should be given slowly in 250 - 500 ml bag to avoid GI symptoms.

Reference: Pharmacokinetic Considerations regarding Tigecycline for Multidrug-Resistant (MDR) Klebsiella pneumoniae or MDR Acinetobacter baumannii Urosepsis - Journal of Clinical Microbiology, May 2009, p. 1613, Vol. 47, No. 5

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