Table 2. Characteristics of patients previously reported with CNS infection treated with intravenous tygecycline.
| Characteristic | Patient 1 (Ray L, et al) | Patient 2 (Jaspan HB, et al) | Patient 3 (Emiroglu M, et al) | Patient 4 (Dandache P, et al) | Patient 5 (Guo W, et al) | Patient 6 (Tutuncu EE, et al) | Patient 7 (Tutuncu EE, et al) | Patient 8 (Wadi JA, et al) | Patient 9 (Gordon NC, et al) | Patient 10 (Shrestha GS, et al) | Patient 11 (De Pascale G, et al) | Patient 12 (Kooli I, et al) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, y/sex | 38y/F | 21-month/F | 5-month/M | 42y/M | 57y/M | 48y/M | 52y/M | 26y/M | 44y/F | 75y/M | 42y/M | 24y/M |
| Country | USA | USA | Turkey | USA | China | Turkey | Turkey | Jordan | UK | Nepal | Italy | Tunisia |
| Underlying disease (s) | Middle cerebral artery strokes | Leukemia, peripheral blood stem cell transplant, muromonab | Ventriculoperitoneal shunt was placed for posthemorrhagic hydrocephalus | Sickle cell disease | Severe traumatic brain injury | T6 vertebral fracture. | L2 - L3 lumbar disk herniation | Multiple injuries to the head, face and extremities | Acoustic neuroma, post-resection CSF leak | Frontal contusion, subdural | Ependymoma 4th ventricle, | Pilocytic astrocytoma |
| Hematoma, EVD | CSF leak, EVD | |||||||||||
| Primary infection | Postoperative cerebritis | Meningitis | Ventriculo-peritoneal shunt meningitis | Meningitis | Ventriculitis | Post-neurosurgical meningitis | Post-neurosurgical meningitis | Post-neurosurgical meningitis | Post-neurosurgical meningitis | EVD-associated ventriculitis | Post-neurosurgical meningitis | Post-neurosurgical ventriculitis |
| Organism (s) | MRAB | Vancomycin-resistant Enterococcus fecium (VRE) | MDRKP | MDRKP | MRAB | MRAB | MRAB | MDR Acinetobacter sp. | Acinetobacter sp. | MRAB | MRAB | MDRAB |
| Tigecycline MIC (mg/L) | 0.75 (CSF) | 0.125 (CSF) | ≤0.5 μg/mL (CSF – E-Test) | 1.0 mg/L (E-test) | ≤1 μg/mL (CSF) | 0.38 μg/ml (CSF) by Etest (AB Biodisk, Solna, Sweden) | 0.38 μg/ml (CSF) by Etest (AB Biodisk) | NA | 2 mg/L | NA | NA | 3.2 mg/L by Etest |
| Tigecycline concentrations (mg/L) | 0.035 – 0.048 (CSF); 0.097 – 0.566 (Serum) | <0.05(CSF) | NA | 0.33 – 0.14 (Serum); 0.12 <0.10 (CSF) | NA | NA | NA | NA | NA | NA | NA | NR |
| Side effects | None | Mildly elevated hepatic transaminases (Drug-drug interactions) | None | None | None | None | None | None | None | Renal dysfunction (CST) | None | None |
| TGC | Tygecicline | Daptomycin (IVT) + Tigecycline | Meropenem (60 days) + Tygecycline | Tygecicline, at twice the daily dose (100 mg every 12 hours) | Polimixin (IVT, IV) + tygecicline iv | IV, 50 mg/q12h | IV, 50 mg/q12 | Tigecycline monotherapy. | Tigecicline | IV, 50 mg/q12h | IV, 50 mg/q12h (check please) | IV, 50 mg/q12h |
| LOT (Days) | 18 days | 14 days | 20 days | ≍ 21 days | NA | ≍ 21 days | ≍ 21 days | NA | 34 days | 14 days | NA | IV, 21 days |
| Co-administered antibiotics | NA | DAP (IVT) | MEM, 60 days | Polimixin (IVT, IV) | NA | Netilmicin IV, (400 mg/q24h),MEM IV, (2g/q8h) | Netilmicin IV, (400 mg/q24h),MEM IV, (2g/q8h) | NA | MEM, 5 days | CST IV, 2 million IU/q8h IVT, 0.2 million IU/q24h | CST IV, 2 million IU/q6h ITH, 150,000 IU/q24h | Colimycin, IV (9 MIU/day) |
| Days to CSF sterilization | 12 | 2 | 6 | 3 | 5 | 21 | 21 | 12 | NA | 7 | 20 | 23 |
| Outcome | Failed to achieve clinical response | Improved | Improved | Improved | Improved | Improved | Improved | Improved | Improved | Improved | Improved | Improved |
CNS, central nervous system; F, female; M, male; CSF, cerebrospinal fluid; EVD, external ventricular drainage; MRAB, multidrug-resistant Acinetobacter baumannii; MDRKP, multi-drug resistant Klebsiella pneumoniae; MDR, multi drug resistant; MIC:mean inhibitory concentration; NA, not available; CST, colistin; TGC, tygecycline; IVT, intraventricular therapy; IV, intravenous; LOT, length of treatment; DAP, daptomycin; MEM, meropenem.