Tigecycline-based prolonged salvage therapy in patients presenting with complex bone and joint infection

Abstract

Objectives: To assess the clinical experience of tigecycline-based salvage therapy in patients presenting with Bone and Joint Infections (BJI).

Patients and methods: Multicenter retrospective cohort study in France and Turkey (2007-2014).

Results: Thirty-six patients (age 58.2±17.8 years; 21 men) were included. The most frequently isolated bacteria were Enterobacteriaceae and staphylococci. Tigecycline (50mg BID, mainly in combination (69.4%), mean duration of 58 days) was indicated for multidrug resistance (90.6%) and/or previous antibiotic intolerance (36.1%), and/or as second- or third-line therapy (69.4%). Six patients (16.7%) experienced early treatment discontinuation for adverse event (4 severe vomiting, 1 pancreatitis, 1 asymptomatic lipase increase). Clinical success was observed in 23 of 30 assessable patients who completed the tigecycline therapy (mean follow-up: 54.1±57.7 weeks).

Conclusion: Prolonged tigecycline-based therapy could be an alternative in patients presenting with BJI requiring salvage therapy, especially if multidrug-resistant Enterobacteriaceae and/or staphylococci are involved.

Keywords: Bone and joint infection; Infection ostéoarticulaire; Tigecycline; Tigécycline.