Prescription Patterns for Tigecycline in Severely Ill Patients for Non-FDA Approved Indications in a Developing Country: A Compromised Outcome.

摘要: Introduction: With the rise in antibiotic resistance, tigecycline has been used frequently off-label indications, based on its in-vitro activity against multidrug-resistant organisms. In this study, our aim was to assess use approved and unapproved indications. Materials Methods: This is a retrospective chart review evaluating 2-year experience of for > 72 hours 153 adult patients inside outside critical care unit from January 2012 December 2013 Lebanese tertiary-care hospital. Results: Tigecycline mostly indications (81%) prescribed area, where number cycles 16/1000 patient days. Clinical success achieved 43.4% patients. critically ill group, it significantly higher with SOFA score < 7 using multivariate analysis (Odds Ratio (OR)= 12.51 [4.29 – 36.51], P<0.0001). Microbiological 43.3% Yet, univariate adjusted models failed show significant difference outcome between vs. those ≥ 7, FDA-approved Total mortality reached approximately 45%. It (OR= 5.17 [2.43 - 11.01], P<0.0001) 4.00 [1.30 12.31], P=0.01) an model. Gram-negative bacteria represented majority clinical isolates Acinetobacter baumannii predominated (28%). Carbapenem resistance present 85% recovered Acinetobacter, yet, more than two third carbapenem-resistant species were still susceptible tigecycline. Conclusion: series, specifically severely The such infections not inferior that especially area. last resort complicated scenarios baseline microbiological epidemiology by extensively-drug resistant pathogens ought be organized.