Tiganex is an intravenous antibiotic containing Tigecycline, a glycylcycline (a derivative of tetracycline). It is a broad-spectrum antibiotic used for complicated infections caused by multidrug-resistant bacteria.
Composition
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Active Ingredient: Tigecycline – 50 mg/vial (lyophilized powder).
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Excipients: Hydrochloric acid, sodium hydroxide, lactose.
Mechanism of Action
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Bacteriostatic (inhibits protein synthesis by binding to the 30S ribosomal subunit).
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Broad-spectrum coverage, including:
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Gram-positive (MRSA, VRE*, Streptococcus spp.)
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Gram-negative (E. coli, Klebsiella, Acinetobacter)
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Anaerobes (Bacteroides fragilis)
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Atypical bacteria (Chlamydia, Mycoplasma)
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Not effective against Pseudomonas aeruginosa or Proteus spp.
(Limited activity against some Enterococcus faecium strains)*
Dosage & Administration
Standard Adult Dose:
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Initial dose: 100 mg IV (single dose).
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Maintenance: 50 mg every 12 hours (infused over 30–60 minutes).
Adjustments:
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Severe hepatic impairment (Child-Pugh C): Reduce maintenance dose to 25 mg every 12 hours.
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No dose adjustment needed for renal impairment.
Pediatrics:
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Not recommended for children <18 years (risk of tooth discoloration & bone growth issues).
Uses (Indications)
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Complicated skin & soft tissue infections (cSSTI)
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Complicated intra-abdominal infections (cIAI)
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Community-acquired bacterial pneumonia (CABP)
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Bacterial infections resistant to other antibiotics
(Not FDA-approved for diabetic foot infections or bacteremia due to higher mortality risk in some studies.)
Storage
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Unreconstituted vials: Store at 20–25°C, protect from light.
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Reconstituted solution:
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Stable for 6 hours at room temperature or 24 hours refrigerated (2–8°C).
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Do not freeze.
Recommendations
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Use only when other antibiotics fail (due to increased mortality risk in some infections).
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Monitor for superinfections (e.g., C. difficile, fungal infections).
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Avoid in pregnancy & breastfeeding (Category D – fetal harm risk).
Important Notes
⚠ Black Box Warning:
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Increased mortality risk observed in some infections (especially hospital-acquired pneumonia).
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Reserve for situations where alternatives are inadequate.
Side Effects:
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Common: Nausea, vomiting, diarrhea.
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Serious: Pancreatitis, hepatic dysfunction, hypersensitivity.
Drug Interactions:
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Warfarin (increased INR monitoring needed).
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Oral contraceptives (reduced efficacy – use backup contraception).
Conclusion
Tiganex (Tigecycline) is a last-resort antibiotic for MDR infections. Use cautiously due to safety concerns and limited spectrum against some pathogens.
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