Tigecycline

Not considered a first-line agent due to Increased all-cause mortality (Black Box Warning)
1. See adverse effects below
Activity
1. Broad Gram Negative and Gram Positive coverage
2. May cover organisms resistant to other Antibiotics
  1. Methicillin-resistant Staphylococcus Aureus
  2. Vancomycin-resistant Enterococcus species
  3. Acinetobacter Baumannii
  4. ESBL Gram-Negative Bacteria
Conditions
1. Community Acquired Pneumonia
  1. Avoid in Hospital Acquired Pneumonia
  2. Avoid in Ventilator Associated Pneumonia
2. Complicated Intraabdominal Infections
  1. Avoid in intestinal perforation
3. Complicated Skin Infections
  1. Avoid in Diabetic Foot Infections

See Tetracyclines
Broad-spectrum glycylcycline Antibiotic derived from Tetracycline
1. Less likely to induce Antibiotic Resistance than other Tetracyclines

Reconstituted Intravenous Fluid should have a yellow orange coloration
Load: 100 mg IV infused over 30 to 60 minutes
Next: 50 mg IV infused over 30 to 60 minutes every 12 hours
1. Decrease dose to 25 mg IV in Child-Pugh C severe liver disease

Avoid in children in general unless no other alternative agent
1. Absolutely contraindicated in children <8 years old
Age 8 to 11 years
1. Give 1.2 mg/kg (up to 50 mg) IV every 12 hours
Age 12 to 17 years
1. Give 50 mg IV every 12 hours

See Tetracyclines
Gastrointestinal (Nausea, Vomiting, Diarrhea)
Black Box Warning
1. Increased all-cause mortality
2. Most associated with hospitalized patients treated for Skin and Soft Tissue Infection
3. Other Antibiotics are therefore preferred
4. Dixit (2014) Expert Rev Anti Infect Ther 12(4):397-400 +PMID: 24597542 [PubMed]