Efficacy of tigecycline for the treatment of complicated skin and soft-tissue infections in real-life clinical practice from five European observational studies

Tigecycline is an approved treatment for complicated skin and soft-tissue infections (cSSTIs). The efficacy of tigecycline as monotherapy or in combination with other antibacterials in the treatment of cSSTI in routine practice is described. Individual patient-level data were pooled from five European observational studies (July 2006 to October 2011). A total of 254 cSSTI patients who received tigecycline were included (mean age 63.214.9 years). Of these, 34.4 were in intensive care units, 54.5 acquired their infection in hospital and 90.9 had at least one comorbidity. Infection most commonly affected the limbs (62.4) and 43.8 of infections were classified as necrotizing. The mean Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores at the beginning of treatment were 15.07.9 (n205) and 5.83.9 (n32), respectively, indicating high disease severity. Staphylococcus aureus (52.7), Escherichia coli (18.0) and Enterococcus faecium (12.0) were the most frequently isolated pathogens; 32.9 of infections were polymicrobial and 30.5 were due to resistant pathogens. Overall, 71.8 received tigecycline as monotherapy and 28.2 as combination therapy for a mean duration of 12 days. Clinical response rates at the end of treatment were 79.6 for all patients who received the standard dosage (183/230), 86.7 for patients who received tigecycline as monotherapy (143/165), 75.0 for patients with a nosocomial infection (96/128), 75.3 for patients with an APACHE II score 15 (61/81) and 58.3 for patients with a SOFA score 7 (7/12). In these real-life studies, tigecycline, alone and in combination, achieved favourable clinical response rates in patients with cSSTI with a high severity of illness.