Severe infections: efficacy and safety of high-dose tigecycline

  • Zha L & al.
  • Adv Ther
  • 31 Jan 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.


  • This meta-analysis suggests that high-dose tigecycline (HDT) treatment demonstrated better clinical outcomes in the treatment of severe infections compared with standard-dose tigecycline and other non-tigecycline-containing regimens.

Why this matters

  • HDT is recommended to patients with multidrug-resistant bacterial infections if a tigecycline-containing regimen is the clinical choice for severe infections.

Study design

  • 10 studies (n=593) met eligibility criteria after a search across electronic databases.
  • Primary outcome: all-cause mortality.
  • Secondary outcomes: clinical cure rate, microbiological eradication rate, and adverse events.
  • Funding: Conch Hospital.

Key results

  • HDT vs placebo group had:
    • lower all-cause mortality (OR, 0.44; 95% CI, 0.30-0.66; P<.0001>
    • higher clinical cure (OR, 3.43; 95% CI, 2.09-5.63; P<.00001 and microbiological eradication rate ci p=".0003).</li">
  • In subgroup analysis, HDT reduced all-cause mortality associated with:
    • hospital-acquired pneumonia (OR, 0.39; 95% CI, 0.22-0.70; P=.002);
    • blood stream infections (OR, 0.19; 95% CI, 0.06-0.58; P=.004); and
    • mixed infections (OR, 0.20; 95% CI, 0.07-0.59; P=.003).
  • No significant difference was observed in complicated intra-abdominal infections between HDT and placebo group (OR, 2.04; 95% CI, 0.80-5.23; P=.14).
  • The incidence of adverse events did not differ between the HDT and placebo group.
  • In carbapenem-resistant pathogens, microbiological eradication rates did not differ between HDT and control group (OR, 1.07; 95% CI, 0.44-2.60; P=.87) but a reduction in mortality was observed in HDT group (OR, 0.20; 95% CI, 0.09-0.45; P=.0001).


  • Most of the studies were observational.
  • Small sample size.