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- Title
A practice-based observational study identifying factors associated with the use of high-dose tigecycline in the treatment of secondary peritonitis in severely ill patients.
- Authors
Maseda, Emilio; Suárez-de-la-Rica, Alejandro; Anillo, Víctor; Salgado, Patricia; Tamayo, Eduardo; García-Bernedo, Carlos A.; Ramasco, Fernando; Villagrán, María-José; López-Tofiño, Araceli; Giménez, María-José; Granizo, Juan-José; Hernández-Gancedo, Carmen; Aguilar, Lorenzo; Gilsanz, Fernando
- Abstract
Introduction. Based on tigecycline linear pharmacokinetic/ pharmacodynamics, dose increases have been advocated to maximise activity especially when severe infections with high bacterial load and/or multidrug resistance are suspected. This practice-based observational study explored factors associated with tigecycline administration (100 mg/12h, 200 mg loading dose) in severely ill patients with complicated intra-abdominal infection (cIAI) admitted to four Surgical Critical Care Units (SCCUs). Methods. Medical records of all consecutive adult patients with cIAI and controlled infection source requiring surgery and admission for ≥48h to SCCU were reviewed and divided into patients treated with a regimen including tigecycline (tigecycline group) and those that not (control group). A logistic regression model was performed using "tigecycline administration" (dependent variable) and variables showing differences (p≤0.1) in bivariate analyses (independent variables). Results. One hundred and twenty one patients were included. In the tigecycline group, higher percentage of patients (vs. controls) presented colon as surgical site (66.7% vs. 41.8%, p=0.006), nosocomial infection (55.6% vs. 26.9%, p=0.001), mechanical ventilation (48.1% vs. 28.4%, p=0.025), chronic renal replacement therapy (40.7% vs. 19.4%, p=0.008), septic shock (72.2% vs. 46.3%, p=0.004), and higher values of SAPS II (48.0±15.0 vs. 39.6±15.5, p=0.003), SOFA at admission (7.0±3.3 vs. 5.5±3.7, p=0.020), lactate-24h (2.5±2.8 vs. 1.6±0.9, p=0.029) and CRP-72h (207.4±87.9 vs. 163.7±76.8, p=0.021). In the multivariate analysis (R2=0.187, p<0.001) nosocomial infection (OR=7.721; 95%CI=2.193, 27.179; p=0.001), colon as infection site (OR=4.338; 95%CI=1.432, 13.145; p=0.009) and CRP-72h (OR=1.009 per-unit; 95%CI=1.002, 1.016; p=0.012) were associated with tigecycline administration. Conclusions. In severely ill patients with cIAI, high-dose tigecycline administration was associated with nosocomial origin of cIAI and colon as source infection site.
- Subjects
PERITONITIS; POSTOPERATIVE period; POSTOPERATIVE care; ANTIBIOTICS; CRITICAL care medicine; DRUG dosage
- Publication
Revista Española de Quimioterapia, 2015, Vol 28, Issue 1, p47
- ISSN
0214-3429
- Publication type
Article