minocycline and Communicable-Diseases

To assess the efficacy and safety of tigecycline in comparison with other antimicrobial treatments for infectious diseases.. Databases of PubMed, Embase and the Cochrane Library were searched through Feb. 2015. The reference lists of the initially identified articles and systemic review articles were manually searched. Randomized controlled trials assessing tigecycline and other antibiotics for infectious diseases in adult patients were included.. Fifteen RCTs including 7689 cases were identified. We found that tigecycline was not as effective as the comparator agents for clinical treatment success (for the clinically evaluable population, odds ratio [OR] = 0.83, 95% confidence interval [CI] = (0.73, 0.96), P=0.01; for the clinically modified intent-to-treat (mITT) population, OR = 0.81, 95% CI = (0.72, 0.92), P=0.001). There was no significant difference in microbiological treatment success with lower eradication rate in tigecycline versus comparators (for the microbiologically evaluable population, OR = 0.94, 95% CI = (0.77, 1.16), P=0.56; for the microbiological mITT populations, OR = 0.91, 95% CI = (0.74, 1.11), P=0.35). Adverse events and all-cause mortality were more common in the tigecycline group.. Tigecycline is not as effective as other antibiotics with relatively more frequency of adverse events and higher mortality rate.

Topics: Adult; Anti-Bacterial Agents; Communicable Diseases; Humans; Infections; Minocycline; Randomized Controlled Trials as Topic; Tigecycline

The aim of this study was to compare the efficacy and safety of tigecycline, a newly developed glycylcycline antibiotic, with those of empirical antibiotic regimens which have been reported to possess good efficacy for complicated skin and skin structure infections (cSSSIs), complicated intra-abdominal infections (cIAIs), community-acquired pneumonia (CAP), and other infections caused by methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE). A meta-analysis of randomized controlled trials (RCTs) identified in PubMed, the Cochrane Library, and Embase was performed. Eight RCTs involving 4,651 patients were included in the meta-analysis. Compared with therapy with empirical antibiotic regimens, tigecycline monotherapy was associated with similar clinical treatment success rates (for the clinically evaluable [CE] population, odds ratio [OR] = 0.92, 95% confidence interval [CI] = 0.76 to 1.12, P = 0.42; for the clinical modified intent-to-treat [c-mITT] population, OR = 0.86, 95% CI = 0.74 to 1.01, P = 0.06) and similar microbiological treatment success rates (for the microbiologically evaluable [ME] population, OR = 0.86, 95% CI = 0.69 to 1.07, P = 0.19). The incidence of adverse events in the tigecycline group was significantly higher than that in the other therapy groups with a statistical margin (for the modified intent-to-treat [mITT] population, OR = 1.33, 95% CI = 1.17 to 1.52, P < 0.0001), especially in the digestive system (mITT population, OR = 2.41, 95% CI = 1.67 to 3.46, P < 0.00001). No difference regarding all-cause mortality and drug-related mortality between tigecycline and the other regimens was found, although numerically higher mortality was found in the tigecycline group. This meta-analysis provides evidence that tigecycline monotherapy may be used as effectively as the comparison therapy for cSSSI, cIAIs, CAP, and infections caused by MRSA/VRE. However, because of the high risk of mortality, AEs, and emergence of resistant isolates, prudence with the clinical use of tigecycline monotherapy in infections is required.

Topics: Anti-Bacterial Agents; Communicable Diseases; Drug Resistance, Bacterial; Enterococcus; Humans; Methicillin-Resistant Staphylococcus aureus; Minocycline; Skin Diseases, Bacterial; Tigecycline; Vancomycin

The first article in this supplement is an overall review of the first glycylcycline, tigecycline, which includes a brief overview of the problem of tetracycline resistance as well as tigecycline's mode of action, antibacterial activity, pharmacokinetics, pharmacodynamics, clinical efficacy, safety and tolerability. The remaining articles in the supplement report the European clinical experience from the pivotal clinical trials in complicated intra-abdominal infections, complicated skin and skin structure infections and community acquired pneumonia.

Topics: Anti-Bacterial Agents; Communicable Diseases; Humans; Minocycline; Tetracycline Resistance; Tigecycline

Tigecycline is an antibiotic with a broad spectrum of activity. Similar to tetracycline antibiotics, tigecycline exerts bacteriostatic activity. Earlier studies documented the safety and efficacy of tigecycline for complicated intra-abdominal and complicated skin and skin-structure infections, which led to its approval. Recent systematic reviews and meta-analyses have suggested increased risk of death in patients receiving tigecycline compared to other antibiotics. The Food and Drug Administration has warned clinicians about increased risk for death in patients who received tigecycline with certain severe infections and have issued a black box warning. The increased mortality risk with tigecycline is most apparent in patients treated for hospital-acquired pneumonia, particularly ventilator-associated pneumonia. The cause of excess deaths in these trials is uncertain, but it is likely that most deaths in patients with these severe infections were related to progression of the infection. Further experience with tigecycline for serious infections with drug-resistant pathogens is currently warranted.

Topics: Anti-Bacterial Agents; Communicable Diseases; Drug Resistance, Multiple, Bacterial; Drug Therapy, Combination; Humans; Male; Minocycline; Pneumonia, Ventilator-Associated; Risk Assessment; Tigecycline; United States; United States Food and Drug Administration

Topics: Anti-Bacterial Agents; Communicable Diseases; Humans; Minocycline; Vancomycin

Topics: Acne Vulgaris; Administration, Oral; Anti-Bacterial Agents; Chlamydia Infections; Chlamydia trachomatis; Communicable Diseases; Humans; Minocycline; Pneumonia, Mycoplasma

Topics: Abnormalities, Severe Teratoid; Central Nervous System Diseases; Communicable Diseases; Congenital Abnormalities; Diseases in Twins; Female; Foot Diseases; Hand Deformities; Humans; Infant; Infant, Newborn; Minocycline; Pregnancy; Pregnancy Complications, Infectious; Rubella