Tigecycline use in children with multidrug-resistant infections: a single-center experience.

BACKGROUND

Pediatric data on tigecycline for multidrug-resistant infections caused by gram-negative bacteria remain scarce. We described clinical outcomes and tolerability of tigecycline in critically ill children at a single tertiary center.

RESEARCH DESIGN AND

METHODS

In this retrospective cohort study, 143 pediatric patients receiving tigecycline (1-1.2 mg/kg or 50 mg twice daily) between January 2018 and September 2023 were analyzed. Most patients (72.0%) required intensive care; 66.4% received combination therapy. Primary outcome was clinical success (infection resolution with marker normalization). Logistic regression and Cox modeling assessed success and mortality predictors; Kaplan-Meier curves compared survival. Paired laboratory data assessed tolerability.

RESULTS

Klebsiella pneumoniae (72.0%) and Acinetobacter baumannii (17.5%) predominated; 87% of isolates displayed carbapenem resistance. Clinical success reached 76.9%. Intensive care admission and combination therapy independently predicted failure. Overall infection-related mortality was 28.7%; intensive care admission was the sole independent mortality predictor. Paired laboratory values showed no significant hepatic, pancreatic, or hematological changes; one biliary sludge event was recorded.

CONCLUSIONS

Tigecycline, a glycylcycline antimicrobial, was associated with favorable outcomes and acceptable tolerability in children with multidrug-resistant infections. The single-center retrospective design, absence of a control group, and frequent concomitant antibiotic use limit generalizability; prospective trials are needed.