Tigecycline use in hospital and its potential role in infection control

Tigecycline is a novel glycylcycline that exhibits broad-spectrum antibacterial activity against a wide range of Gram-negative and Gram-positive bacterial species, including clinically important multi-drug-resistant nosocomial and community-acquired bacterial pathogens. Notably, tigecycline overcomes the action of ribosomal protection proteins and is not a substrate for the tetracycline efflux pumps of most bacteria - well-known and prevalent cellular mechanisms of microbial tetracycline resistance. Recently, the US Food and Drug Administration issued a warning concerning increased mortality with tigecycline in randomised controlled trials; however, in the labelled indications, complicated skin and skin structure infections (cSSSIs) and complicated intra-abdominal infections (cIAIs), in the authors' opinion tigecycline's benefits outweigh the potential risks. The present article summarises the current position on the use of tigecycline in the treatment of cSSSIs, cIAIs, ventilator-associated pneumonia and Clostridium difficile and the potential role of this drug in infection control.