Overview of tigecycline and its role in the era of antibiotic resistance.

The increasing antimicrobial resistance found in the many clinically important species of bacteria that commonly cause serious and life-threatening diseases presents a difficult challenge for clinicians, especially when an appropriate initial therapy must be chosen. New antibiotics are urgently needed to address the formidable issues associated with infections caused by vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), penicillin-resistant Streptococcus pneumoniae and multidrug-resistant Gram-negative bacteria. The need for new antibiotics that effectively resist antimicrobial mechanisms of resistance has become paramount. Tigecycline is a new antimicrobial agent; it is the first in a new class of antibiotics, the glycylcyclines, with properties conferring the ability to overcome many common resistance mechanisms, thus allowing the use of tigecycline for many serious and life-threatening infections for which the use of other antibiotics is no longer appropriate. Tigecycline is a novel expanded spectrum antibiotic that appears poised to meet the latest bacterial challenges facing clinicians, including the serious and life-threatening infections caused by highly resistant bacteria. Tigecycline, moreover, appears to hold promise as a new, versatile antibiotic that can be chosen for empirical therapy, even as a single agent, for initial therapy of many clinically important infections.