Tigecycline for the treatment of patients with severe sepsis or septic shock: a drug use evaluation in a surgical intensive care unit

Objectives: Adequate antimicrobial therapy is crucial for the survival of critically ill patients with severe nosocomial infections. Tigecycline, the first available agent in the new class of glycylcyclines, is active against multiresistant Gram-positive and Gram-negative bacteria. The aim of this observa-tional, retrospective evaluation was to assess tigecycline use patterns in a surgical intensive care unit (SICU) of a tertiary care centre. Methods: Data from 70 patients receiving tigecycline in the SICU were analysed. We reviewed tigecy-cline use in terms of demographic data and co-morbidities, disease severity, clinical indication, micro-biology, therapy regimens and mortality. A logistic regression analysis was performed to identify prognostic factors for mortality. Results: The majority of patients had co-morbidities such as cancer (51%) or renal replacement therapy (57%). The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score of patients at admission was 27. Intra-abdominal infection was most frequently diagnosed (50 % of patients); intra-abdominal infection and pneumonia were diagnosed in 14%. Methicillin-resistant Staphylococcus aureus was found in 16 % of patients (colonization; infection: 6%) and vancomycin-resistant enterococci in 27 % (colonization; infection: 21%). The mean duration of tigecycline therap