is a glycylcycline antibacterial structurally related to the tetracyclines; side effects similar to those of the tetracyclines can potentially occur. Tigecycline is active against Gram-positive and Gram-negative bacteria, including tetracycline-resistant organisms, and some anaerobes. It is also active against meticillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, but Pseudomonas aeruginosa and many strains of Proteus spp are resistant to tigecycline.

Tigecycline should be reserved for the treatment of complicated skin and soft-tissue infections and complicated abdominal infections caused by multiple- antibacterial resistant organisms when other antibacterial cannot be used; it is not recommended for the treatment of foot infections in patients with diabetes.

Indications: Tigecycline is active against Gram-positive and Gram-negative bacteria, including tetracycline- resistant organisms, and some anaerobes. It is also active against meticillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, but Pseudomonas aeruginosa and many strains of Proteus spp are resistant to tigecycline. Tigecycline should be reserved for the treatment of complicated skin and soft-tissue infections and complicated abdominal infections caused by multiple-antibacterial resistant organisms when other antibacterial cannot be used; it is not recommended for the treatment of foot infections in patients with diabetes.

Cautions: cholestasis

Contra-indications: hypersensitivity to tetracyclines Hepatic impairment: initially 100 mg then 25 mg every 12 hours in severe impairment.

Breast-feeding: manufacturer advises caution (present in milk in animal studies).

Pregnancy: should not be given to pregnant women.

Side Effects: nausea, vomiting, abdominal pain, dyspepsia, diarrhoea, anorexia, bilirubinaemia, dizziness, headache, hypoglycaemia, prolonged prothrombin time, prolonged activated partial thromboplastin time, rash, pruritus, and injection-site reactions; less commonly pancreatitis, cholestatic jaundice, and hypoproteinaemia; also reported, antibiotic-associated colitis, hepatic failure, thrombocytopenia, Stevens-Johnson syndrome.

Dose: By intravenous infusion, ADULT over 18 years,

initially 100 mg, then 50 mg every 12 hours for 5–14 days.