Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Tigecycline is an antibiotic that is used
intravenously for the treatment of infections of the skin and abdominal organs
caused by bacteria that are susceptible to it. Tigecycline is similar to
tetracycline antibiotics and has activity against a large number of bacteria.
Tigecycline binds to bacterial ribosomes, organelles inside the bacteria that
produce the cell's proteins. The binding prevents the bacterial ribosomes from
producing important proteins that are needed for growth and multiplication of
the bacteria. Tigecycline prevents a bacterium from multiplying, but it does not
kill the bacterium. Tigecycline was approved by the FDA in June, 2005.
PRESCRIPTION: Yes.
GENERIC AVAILABLE: No.
PREPARATIONS: Single dose vial: 5 ml; 50 mg powder for reconstitution.
STORAGE: The powder should
be stored at room temperature between 15-30°C (59-86°F). Once mixed, it may be
stored at room temperature for up to 24 hours (up to six hours in the vial and
the remaining time in the intravenous bag or refrigerated at 2-8° C (36-46° F) for up to 45 hours in an intravenous bag.
Tigecycline is used for treating complicated intra-abdominal infections caused by susceptible strains of Citrobacter freundii, Enterobacter cloacae, Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Enterococcus faecalis, Staphylococcus aureus, Streptococcus anginosus group, Bacteroides fragilis, Bacteroides thetaiotaomicron, Bacteroides uniformis, Bacteroides vulgatus, Clostridium perfringens, and Peptostreptococcus micros.
Tigecycline alsois used for treating community-acquired bacterial
pneumonia caused by Streptococcus pneumoniae, Haemophilus
influenzae,and Legionella pneumophila.
To prevent resistance, tigecycline should only be used to treat infections caused or very likely to be caused by susceptible strains of bacteria.
DOSING: Tigecycline is
administered via intravenous infusions over 30-60 minutes. The initial
dose is 100 mg followed by 50 mg every 12 hours. The usual duration of
treatment is 5-14 days for complicated skin infections or for complicated intra-abdominal infections. The recommended duration of treatment for community-acquired bacterial pneumonia is 7-14 days.
DRUG INTERACTIONS: Tigecycline
may decrease the elimination of the blood thinner warfarin thereby
increasing warfarin levels in blood. Although the effect of warfarin is not
increased, the effect on warfarin and the potential increased risk of bleeding
should be monitored by tests of bleeding.
PREGNANCY: Administration of
tigecycline to pregnant women may cause harm to the fetus, and use during tooth
development may cause permanent discoloration of teeth.
NURSING MOTHERS: Use of
tigecycline in nursing women has not been adequately studied. It is not known
whether tigecycline is excreted in human breast milk.
.
SIDE EFFECTS: The most common
side effects of tigecycline are diarrhea, nausea and vomiting. Nausea and
vomiting is mild or moderate and usually occurs during the first two days of
therapy. Other side effects include pain at the injection site, swelling and irritation; increased or decreased heart rate and
infections. Tigecycline is similar to tetracycline antibiotics and therefore may
have similar side effects such as increased sensitivity to sunlight. As with
other antibiotics, overgrowth of organisms that are not susceptible to tigecycline can occur.
Reference: Tygacil Full Prescribing
Information. Wyeth Pharmaceuticals Inc.
NDM-1 (New Delhi metallo-beta-lactamase) is an enzyme produced by certain strains of bacteria that have recently acquired the genetic ability to make this compound. Bacteria that produce NDM-1 are resistant to all commonly used beta-lactam antibiotics. Klebsiella, Escherichia and Acinetobacter are known to possess the gene for NDM-1, which can turn these bacteria into superbugs. Symptoms and signs of NDM-1 infection include fever, fatigue, and shock. Treatment depends upon the NDM-1 strain.
NDM-1 stands for New Delhi metallo-beta-lactamase, which is an enzyme
produced by certain strains of bacteria that have recently acquired the genetic
ability to make this compound. The enzyme is active against other compounds that
contain a chemical structure known as a beta-lactam ring. Unfortunately, many
antibiotics contain this ring, including the penicillins, cephalosporins, and the
carbapenems.
There are many types of beta-lactamases. Most are only active against older
beta-lactam antibiotics but are not active against newer agents like the
carbapenems. However, bacteria that produce NDM-1 are resistant to all commonly
used beta-lactam antibiotics, including carbapenems. Some antibiotics like
aminoglycosides and fluoroquinolones do not contain beta-lactam rings.
Unfortunately, the bacteria that have acquired NDM-1 have also acquired other
resistance factors and most are already resistant to aminoglycosides and ...
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