TYGACIL provides an expanded broad spectrum of in vitro activity1,23
- Gram-positive pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus epidermidis (MRSE), and vancomycin-resistant enterococci (VRE)—Enterococcus faecalis and Enterococcus faecium1
- Gram-negative pathogens, including Acinetobacter baumannii and Stenotrophomonas maltophilia1
- Anaerobic pathogens1
- Rapidly growing mycobacteria1
The clinical significance of in vitro activity is unknown.1
Tigecycline is generally considered bacteriostatic; however, TYGACIL has demonstrated bactericidal activity against isolates of S. pneumoniae and
L. pneumophila.1
TYGACIL in vitro activity
| Microorganisms | Strain |
|---|---|
| Gram positives | Staphylococcus aureus (MSSA)*† Staphylococcus epidermidis (MSSE) Staphylococcus haemolyticus Streptococcus agalactiae* Streptococcus pneumoniae (penicillin-susceptible isolates)‡ Streptococcus pyogenes* Streptococcus anginosus grp. (includes S. anginosus, S. intermedius, and S. constellatus)*† Enterococcus faecalis (vancomycin-susceptible isolates)*† Enterococcus faecium (vancomycin-susceptible isolates) Enterococcus avium Enterococcus casseliflavus Enterococcus gallinarum Listeria monocytogenes |
| Gram negatives | Citrobacter freundii † Enterobacter aerogenes Enterobacter cloacae*† Escherichia coli *† Haemophilus influenzae (beta-lactamase negative isolates)‡ Haemophilus parainfluenzae Klebsiella oxytoca† Klebsiella pneumoniae*† Aeromonas hydrophila Citrobacter koseri Pasteurella multocida Serratia marcescens |
| Anaerobes | Bacteroides fragilis*† Bacteroides uniformis† Bacteroides vulgatus† Bacteroides thetaiotaomicron† Bacteroides distasonis Bacteroides ovatus Prevotella spp. Clostridium perfringens† Peptostreptococcus micros† Peptostreptococcus spp. Porphyromonas spp. |
| Atypicals | Legionella pneumophila‡ |
| Resistant gram positives | Staphylococcus aureus (MRSA)*† Staphylococcus epidermidis (MRSE) Enterococcus faecalis (VRE) Enterococcus faecium (VRE) |
| Resistant gram negatives | Acinetobacter baumannii § Stenotrophomonas maltophilia TYGACIL is not affected by extended-spectrum beta-lactamases (ESBLs). |
| Other | Mycobacterium abscessus Mycobacterium fortuitum |
TYGACIL does not cover Pseudomonas aeruginosa.
The clinical significance of in vitro activity is unknown.
* Clinical efficacy has been demonstrated for susceptible isolates in cSSSI.
† Clinical efficacy has been demonstrated for susceptible isolates in cIAI.
‡ Clinical efficacy has been demonstrated for susceptible isolates in CABP.
§ There have been reports of the development of tigecycline resistance in Acinetobacter baumannii infections. Such resistance appears to be attributable to an MDR efflux pump mechanism. Please see the full Prescribing Information for additional information regarding Acinetobacter.
The Tigecycline Evaluation and Surveillance Trial (T.E.S.T.) database confirms the expanded broad spectrum of in vitro activity of TYGACIL.31 Learn more about T.E.S.T.
Indications and Important Safety Information
Indications
TYGACIL® (tigecycline) is indicated for the treatment of adults with:
- Complicated skin and skin structure infections caused by Escherichia coli, Enterococcus faecalis (vancomycin-susceptible isolates), Staphylococcus aureus (methicillin-susceptible and -resistant isolates), Streptococcus agalactiae, Streptococcus anginosus grp. (includes S. anginosus, S. intermedius, and S. constellatus), Streptococcus pyogenes, Enterobacter cloacae, Klebsiella pneumoniae, and Bacteroides fragilis
- Complicated intra-abdominal infections caused by Citrobacter freundii, Enterobacter cloacae, Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Enterococcus faecalis (vancomycin-susceptible isolates), Staphylococcus aureus (methicillin-susceptible and -resistant isolates), Streptococcus anginosus grp. (includes S. anginosus,
S. intermedius, and S. constellatus), Bacteroides fragilis, Bacteroides thetaiotaomicron, Bacteroides uniformis, Bacteroides vulgatus, Clostridium perfringens, and Peptostreptococcus micros - Community-acquired bacterial pneumonia caused by Streptococcus pneumoniae (penicillin-susceptible isolates), including cases with concurrent bacteremia, Haemophilus influenzae (beta-lactamase negative isolates), and Legionella pneumophila
Important Safety Information
- TYGACIL is contraindicated in patients with known hypersensitivity to tigecycline
- Anaphylaxis/anaphylactoid reactions have been reported with nearly all antibacterial agents, including tigecycline, and may be life-threatening. TYGACIL should be administered with caution in patients with known hypersensitivity to tetracycline-class antibiotics
- Isolated cases of significant hepatic dysfunction and hepatic failure have been reported in patients being treated with tigecycline. Some of these patients were receiving multiple concomitant medications. Patients who develop abnormal liver function tests during tigecycline therapy should be monitored for evidence of worsening hepatic function. Adverse events may occur after the drug has been discontinued
- The safety and efficacy of TYGACIL in patients with hospital-acquired pneumonia have not been established
- An increase in all-cause mortality has been observed across phase 3 and 4 clinical studies in TYGACIL-treated patients versus comparator-treated patients. The cause of this increase has not been established. This increase in all-cause mortality should be considered when selecting among treatment options
- TYGACIL may cause fetal harm when administered to a pregnant woman
- The use of TYGACIL during tooth development may cause permanent discoloration of the teeth. TYGACIL should not be used during tooth development unless other drugs are not likely to be effective or are contraindicated
- Acute pancreatitis, including fatal cases, has occurred in association with tigecycline treatment. Consideration should be given to the cessation of the treatment with tigecycline in cases suspected of having developed pancreatitis
- Clostridium difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including TYGACIL, and may range in severity from mild diarrhea to fatal colitis
- Monotherapy should be used with caution in patients with clinically apparent intestinal perforation
- TYGACIL is structurally similar to tetracycline-class antibiotics and may have similar adverse effects. Such effects may include: photosensitivity, pseudotumor cerebri, and anti-anabolic action (which has led to increased BUN, azotemia, acidosis, and hyperphosphatemia). As with tetracyclines, pancreatitis has been reported with the use of TYGACIL
- To reduce the development of drug-resistant bacteria and maintain the effectiveness of TYGACIL and other antibacterial drugs, TYGACIL should be used only to treat infections proven or strongly suspected to be caused by susceptible bacteria. As with other antibacterial drugs, use of TYGACIL may result in overgrowth of non-susceptible organisms, including fungi
- The most common adverse reactions (incidence >5%) are nausea, vomiting, diarrhea, abdominal pain, headache, and increased SGPT
- Prothrombin time or other suitable anticoagulant test should be monitored if TYGACIL is administered with warfarin
- Concurrent use of antibacterial drugs with oral contraceptives may render oral contraceptives less effective
- The safety and effectiveness of TYGACIL in patients below age 18 and lactating women have not been established
Please see full Prescribing Information.