Widebac IV

Indications

Tigecycline is an intravenous antibiotic used in hospital for complicated skin and soft tissue infections and complicated infections inside the abdomen, when other antibiotics are not suitable. It is often reserved for infections caused by multidrug resistant bacteria. It is not used for diabetic foot infections or hospital acquired pneumonia because it worked less well in these.

How It Works

Tigecycline belongs to the glycylcycline group, related to tetracyclines. It binds to the bacterial ribosome, the part of the cell that makes proteins, and stops bacteria from growing. It is designed to work against many bacteria that resist tetracyclines.

Dosage and Administration

Tigecycline is given by a doctor or nurse as a slow infusion into a vein, usually over 30 to 60 minutes, every 12 hours. A higher first dose (loading dose) is given at the start. Treatment usually lasts 5 to 14 days. People with severe liver disease need a lower dose. Dosing is as prescribed.

Interactions

• Warfarin: blood clotting tests (INR) should be monitored.
• It may make oral contraceptive pills less effective.
• Ciclosporin and Tacrolimus levels may rise and need checking.

Contraindications

Allergy to Tigecycline. Use with caution in people allergic to tetracycline antibiotics.

Side Effects

Nausea and vomiting are very common. Other effects include diarrhoea, abdominal pain, headache, dizziness, raised liver enzymes, changes in blood clotting, low platelets, and pain or swelling at the infusion site.

Get urgent medical help, or tell the nurse straight away, if you have severe stomach pain with vomiting (possible pancreatitis), yellowing of the skin or eyes, unusual bleeding or bruising, severe watery or bloody diarrhoea, or signs of a severe allergic reaction. Studies have shown a higher risk of death with tigecycline than with some other antibiotics, so it is used only when alternatives are not suitable.

Pregnancy and Lactation

Tigecycline can harm the unborn baby and cause permanent tooth discolouration if used in the second half of pregnancy. It is used in pregnancy only if there is no suitable alternative. Discuss breastfeeding with the doctor.

Precautions and Warnings

• Not recommended for children under 8 years, as it can stain developing teeth.
• Liver tests, blood clotting and blood counts may be monitored.
• It may cause sensitivity to sunlight; avoid strong sun.
• Prolonged use can cause overgrowth of resistant organisms, including fungi.

Overdose

Overdose is unlikely because it is given in hospital. High doses mainly increase nausea and vomiting. Staff will give supportive care.

Therapeutic Class

Glycylcycline antibiotic.

Storage

Hospital medicine: store as directed on the pack, below 25°C, out of the reach of children. Prepared solutions are used promptly or stored as directed.