Daniel Curcio, Sandra Whittle Vargas, Sebastian Ugarte Ubiergo, Fabio Varon, Jose Rojas Suarez, Carlos Paz Chavez and Ariel Curiale Pages 18-25 (8)
We analyzed the tigecycline prescriptions in 209 patients in 23 Latin American centres using an electronic form included in the website LatinUser™ (http://www.clinicalrec.com.ar).
Sixty-six patients (31.5%) received tigecycline for approved indications, and 143 (68.5%) for “off label” indications (47% with scientific support and 21.5% with limited or without any scientific support). The most frequent “off label” use was ventilator-associated pneumonia (VAP) (76 patients).
The etiology of infections was established in 88 patients (42%). Acinetobacter spp. (54.5%, in 65% of cases carbapenemsresistant), methicillin-resistant Staphylococcus aureus (12%), and extended spectrum β-lactamases-producing Enterobacteriaceae (10%) were the most common microorganisms isolated.
Overall, attending physicians reported clinical success in 144 of the 209 patients (69%). Global mortality proportion was 35.5% (74/209 patients).
Our study shows that the off label use of tigecycline is frequent, especially in VAP due to multidrug-resistant pathogens, where the therapeutic options are limited (e.g.: carbapenems-resistant Acinetobacter spp.). Physicians must evaluate the benefits/risks to use this antibiotic for indications that lack rigorous scientific support.
Acinetobacter spp, off-label, Latin America, multidrug-resistant pathogens, tigecycline, ventilator-associated pneumonia, Latin America, , A. baumannii infections, enzymes, Pseudomonas aeruginosa, lactamases
Instituto Sacre Cour, Infectologia Institucional SRL, Santo Tome 5239 4to 22 (1419) Capital Federal, Argentina.