Death Rates No Lower With High-Dose Tigecycline for OAs With Drug-Resistant A. Baumannii

High-dose tigecycline was not associated with lower 30-day crude mortality in older adults in  intensive care for pneumonia caused by multidrug-resistant Acinetobacter baumannii compared with standard-dose tigecycline, according to a study published in the journal Infection and Drug Resistance. 

“In this study, we found that there was no significant difference between the two groups in the 30-day deaths,” researchers wrote. “The high dose of tigecycline did not improve the survival days and number of hospital days for the elderly.” 

The observational retrospective cohort study included 48 patients age 60 or older in six intensive care units at Xuan Wu Hospital Capital Medical University in China. Patients were treated with either standard-dose tigecycline (an initial dose of 100 mg of intravenous tigecycline, followed by 50-mg intravenous doses twice daily) or high-dose tigecycline (an initial 200 mg intravenous tigecycline, followed by 100-mg intravenous doses twice daily) for hospital-acquired/ventilator-associated pneumonia caused by microbially confirmed A. baumannii infection. 

Analysis of 33 patients in the standard-dose group and 15 patients in the high-dose group showed no significant difference in 30-day deaths between the two groups, researchers reported. However, microbiological eradication percentages were higher with high-dose tigecycline: 66.7%, compared with 61.5% with standard-dose tigecycline. 

Variables associated with 30-day crude mortality were chronic obstructive pulmonary disease, surgery before infection, and duration of tigecycline treatment, according to the study.

“In conclusion, high-dose tigecycline was unassociated with lower crude mortality in elderly patients with pneumonia due to multidrug-resistant A. baumannii, and it benefitted eradicating A. baumannii in the intensive care unit,” researchers wrote. “Prospective cohort studies or random clinical trials are needed to confirm these preliminary results.” 

—Jolynn Tumolo

Reference:

Bai XR, Jiang DC, Yan SY. High-Dose Tigecycline in Elderly Patients with Pneumonia Due to Multidrug-Resistant Acinetobacter baumannii in Intensive Care Unit. Infect Drug Resist. 2020;13:1447-1454. Published 2020 May 18. doi:10.2147/IDR.S249352