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De Pascale G, Lisi L, Ciotti GMP, et al. Pharmacokinetics of high-dose tigecycline in critically ill patients with severe infections. Ann Intensive Care. 2020;10(1):94doi: 10.1186/s13613-020-00715-2.
De Pascale, G., Lisi, L., Ciotti, G. M. P., Vallecoccia, M. S., Cutuli, S. L., Cascarano, L., Gelormini, C., Bello, G., Montini, L., Carelli, S., Di Gravio, V., Tumbarello, M., Sanguinetti, M., Navarra, P., & Antonelli, M. (2020). Pharmacokinetics of high-dose tigecycline in critically ill patients with severe infections. Annals of intensive care, 10(1), 94. https://doi.org/10.1186/s13613-020-00715-2
De Pascale, Gennaro, et al. "Pharmacokinetics of high-dose tigecycline in critically ill patients with severe infections." Annals of intensive care vol. 10,1 (2020): 94. doi: https://doi.org/10.1186/s13613-020-00715-2
De Pascale G, Lisi L, Ciotti GMP, Vallecoccia MS, Cutuli SL, Cascarano L, Gelormini C, Bello G, Montini L, Carelli S, Di Gravio V, Tumbarello M, Sanguinetti M, Navarra P, Antonelli M. Pharmacokinetics of high-dose tigecycline in critically ill patients with severe infections. Ann Intensive Care. 2020 Jul 13;10(1):94. doi: 10.1186/s13613-020-00715-2. PMID: 32661791; PMCID: PMC7357259.
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Ann Intensive Care. 2020 Jul 13;10(1):94. doi: 10.1186/s13613-020-00715-2.

Pharmacokinetics of high-dose tigecycline in critically ill patients with severe infections.

Annals of intensive care

Gennaro De Pascale, Lucia Lisi, Gabriella Maria Pia Ciotti, Maria Sole Vallecoccia, Salvatore Lucio Cutuli, Laura Cascarano, Camilla Gelormini, Giuseppe Bello, Luca Montini, Simone Carelli, Valentina Di Gravio, Mario Tumbarello, Maurizio Sanguinetti, Pierluigi Navarra, Massimo Antonelli

Affiliations

  1. Dipartimento di Scienza dell'Emergenza, Anestesiologiche e della Rianimazione - UOC di Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy. [email protected].
  2. Istituto di Anestesia e Rianimazione, Università Cattolica del Sacro Cuore, Rome, Italy. [email protected].
  3. Institute of Farmacologia, Università Cattolica del Sacro Cuore, L.go F. Vito 1, Rome, Italy.
  4. Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
  5. Dipartimento di Scienza dell'Emergenza, Anestesiologiche e della Rianimazione - UOC di Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy.
  6. Istituto di Anestesia e Rianimazione, Università Cattolica del Sacro Cuore, Rome, Italy.
  7. Dipartimento di Scienze di Laboratorio e Infettivologiche, UOC di Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  8. Istituto di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy.
  9. Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Rome, Italy.
  10. Dipartimento di Scienze di Laboratorio e Infettivologiche, UOC di Microbiologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

PMID: 32661791 PMCID: PMC7357259 DOI: 10.1186/s13613-020-00715-2

Abstract

BACKGROUND: In critically ill patients, the use of high tigecycline dosages (HD TGC) (200 mg/day) has been recently increasing but few pharmacokinetic/pharmacodynamic (PK/PD) data are available. We designed a prospective observational study to describe the pharmacokinetic/pharmacodynamic (PK/PD) profile of HD TGC in a cohort of critically ill patients with severe infections.

RESULTS: This was a single centre, prospective, observational study that was conducted in the 20-bed mixed ICU of a 1500-bed teaching hospital in Rome, Italy. In all patients admitted to the ICU between 2015 and 2018, who received TGC (200 mg loading dose, then 100 mg q12) for the treatment of documented infections, serial blood samples were collected to measure steady-state TGC concentrations. Moreover, epithelial lining fluid (ELF) concentrations were determined in patients with nosocomial pneumonia. Amongst the 32 non-obese patients included, 11 had a treatment failure, whilst the other 21 subjects successfully eradicated the infection. There were no between-group differences in terms of demographic aspects and main comorbidities. In nosocomial pneumonia, for a target AUC

CONCLUSIONS: The use of HD TGC is associated with satisfactory plasmatic and pulmonary concentrations for the treatment of severe infections due to fully susceptible bacteria (MIC < 0.5 mcg/mL). Even higher dosages and combination strategies may be suggested in presence of difficult to treat pathogens, especially in case of SSTI and IAI.

Keywords: Critically ill patients; Epithelial lining fluid; High dose; Pharmacokinetics; Severe infections; Tigecycline

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