Tigecycline Use in Pediatrics: A Comprehensive Analysis of Clinical, Laboratory, and Microbiological Factors.

OBJECTIVE

This study aimed to evaluate the indications and clinical and microbiological outcomes of tigecycline use in pediatric patients and to analyze the factors associated with treatment success and mortality.

METHODS

The patients receiving tigecycline antibiotic therapy at a tertiary university hospital over a 12-year period were evaluated.

RESULTS

During the study period, tigecycline was used in 66 patients. The median age of the patients was 11 years (range: 2 months to 18 years), and 40 (60.6%) were male. While 53% of the patients received empirical treatment, 46.9% received targeted therapy. The majority of patients (81.8%) received tigecycline for "off-label" indications, with bacteremia being the most common "off-label" indication. Microbiological and clinical success rates were 77.1% and 66.7%, respectively. While clinical success did not differ significantly between empiric and targeted therapy groups (P=.22), microbiological success was significantly higher in the targeted therapy group (P=.02). No statistically significant differences were observed between indication types. However, mortality was higher in patients with bacteremia who were treated with tigecycline compared with the non-bacteremic group (P=.007). Tigecycline was combined with other antibiotics in all patients. No serious adverse events requiring discontinuation of tigecycline treatment or dose revision were observed during follow-up.

CONCLUSIONS

This study suggests that tigecycline, due to its broad spectrum of antibacterial activity, may be an important option in children in combination with other antibiotics in the absence of alternative options or in the absence of response to treatment.