The analyses of the clinical data from 63 cases with sepsis treated by tigecycline

SHEN Jianliang; LIU Yi; XIE Bangtie; ZHANG Zhicheng; HAN Zhihai; WANG Yuhong

doi:10.3969/j.issn.2095-3097.2016.05.006

Abstract：Objective To evaluate the efficacy and safety of tigecycline for the treatment of sepsis, and propose some measures for improving its efficacy. Methods Clinical data of 63 cases with sepsis treated by tigecycline were analyzed retrospectively. Results The febrile period for these patients ahead of the administrations of tigecycline was from 5 to 135 days with a median of 21 days. The time for antimicrobial treatment pre-tigecycline was 3 to 135 days with a median of 19 days. 66. 7% of the patients had received three or more kinds of antibacterial agents ( excluding antifungal agents) ahead of tigecycline treatment. The predominant infectious position was lung. 55 strains had been detected from 39 cases, and 78.2% of them were gram-negative microorganisms. The two most frequently detected pathogens were Acinetobacter baumannii and Pseudomonas aeruginosa. 51 strains of MDR and XDR were documented and occupied 92.7% of all strains. 96.8% of cases had received the combination therapy of tigecycline and other antibacterial agents. The most frequently combined antibacterial agents were the drugs against gram-negative pathogens. The duration of the administra-tions of tigecycline was 4 to 36 days with a median of 9 days. The overall response rate for tigecycline was 23.8%, and the median febricide time was 8 days. The efficacy of tigecycline were not affected by the ex vivo susceptibility of the pathogens, the kinds and numbers of the combined antibacterial agents, and the usage of steroids, but the efficacy of tigecycline used for 9 days or more was signifi-cantly better than that for less than 9 days (χ2=7. 007,P=0. 008). The incidence of the adverse events occurring mainly in digestive system was low. Conclusion The response rate of tigecycline in the treatment of espsis was relatively low, and the strategy of the administrations of tigecycline should be improved. The adverse events were mild.