Dataset Information

Tigecycline application in a 3-month-old infant with multiple drug resistant Klebsiella pneumonia: a case report.

ABSTRACT:

Background

Tigecycline is an 'immature' antibiotic for children. We report the youngest surviving patient who received a complete tigecycline treatment, and no significant adverse effects occurred in the patient.

Case presentation

The 3-month old infant suffered from a catheter-associated bloodstream infection by multiple drug resistant Klebsiella pneumoniae. Tigecycline was considered as a salvage therapy to control the severe sepsis. The therapy consisted of 3 mg/kg as a loading dose and 1.5 mg/kg Q12 h as a maintenance dose for 26 days.

Conclusion

Current researches are limited in clinical trials directly focused on children. This therapeutic schedule might be safe for patients who are above 3 months old.

SUBMITTER: Peng C

PROVIDER: S-EPMC6014034 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

Tigecycline application in a 3-month-old infant with multiple drug resistant <i>Klebsiella pneumonia</i>: a case report.

Peng Cheng C Wang Xiaofeng X Zhang Jiangwei J Jiang Yi Y Hou Xinlin X

Gut pathogens 20180622

<h4>Background</h4>Tigecycline is an 'immature' antibiotic for children. We report the youngest surviving patient who received a complete tigecycline treatment, and no significant adverse effects occurred in the patient.<h4>Case presentation</h4>The 3-month old infant suffered from a catheter-associated bloodstream infection by multiple drug resistant <i>Klebsiella pneumoniae</i>. Tigecycline was considered as a salvage therapy to control the severe sepsis. The therapy consisted of 3 mg/kg as a ...[more]

PMID: 29977345

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Project description:Background: Recent scientific reports on the use of high dose tigecycline monotherapy as a "drug of last resort" warrant further research into the use of this regimen for the treatment of severe multidrug-resistant, Gram-negative bacterial infections. In the current study, the therapeutic efficacy of tigecycline monotherapy was investigated and compared to meropenem monotherapy in a newly developed rat model of fatal lobar pneumonia-septicemia. Methods: A Klebsiella pneumoniae producing extended-spectrum β-lactamase (ESBL) and an isogenic variant producing K. pneumoniae carbapenemase (KPC) were used in the study. Both strains were tested for their in vitro antibiotic susceptibility and used to induce pneumonia-septicemia in rats, which was characterized using disease progression parameters. Therapy with tigecycline or meropenem was initiated at the moment that rats suffered from progressive infection and was administered 12-hourly over 10 days. The pharmacokinetics of meropenem were determined in infected rats. Results: In rats with ESBL pneumonia-septicemia, the minimum dosage of meropenem achieving survival of all rats was 25 mg/kg/day. However, in rats with KPC pneumonia-septicemia, this meropenem dosage was unsuccessful. In contrast, all rats with KPC pneumonia-septicemia were successfully cured by administration of high-dose tigecycline monotherapy of 25 mg/kg/day (i.e., the minimum tigecycline dosage achieving 100% survival of rats with ESBL pneumonia-septicemia in a previous study). Conclusions: The current study supports recent literature recommending high-dose tigecycline as a last resort regimen for the treatment of severe multidrug-resistant bacterial infections. The use of ESBL- and KPC-producing K. pneumoniae strains in the current rat model of pneumonia-septicemia enables further investigation, helping provide supporting data for follow-up clinical trials in patients suffering from severe multidrug-resistant bacterial respiratory infections.