Tigecycline (Tygacil) is an intravenous glycylcycline antibiotic used to treat a variety of skin/soft tissue infections, complicated intra-abdominal infections, and community-acquired pneumonia (NOT hospital/ventilator-acquired pneumonias).
Glycylcyclines are structurally similar to tetracyclines with less antibiotic resistance and confer bacteriostatic effects in a similar way by binding the 30S bacterial ribosomal subunit. Tigecycline provides broad coverage including gram positives (even VRE/MRSA), gram negatives, atypicals, and anaerobes; however, a notable gap in its coverage profile is Pseudomonas!
A meta-analysis from 2010 resulted in an FDA black box warning regarding increased risk of death when tigecycline is used for indicated AND off-label purposes (namely hospital-acquired pneumonia). Therefore, it should only be used in clinical situations where alternatives are not available. More commonly, the routine side effect profile is centered around the GI tract and includes diarrhea, nausea, vomiting, and transaminitis.
Have you seen tigecycline used? Drop me a comment with questions below!