Exploratory pharmacokinetic/pharmacodynamic range of tigecycline for balancing treatment effect and safety in hospital-acquired pneumonia: a retrospective cohort study
Abstract
Tigecycline (TGC) is a core antibiotic for treating hospital-acquired pneumonia (HAP) caused by multidrug-resistant (MDR) bacteria, but the absence of individualized dosing guidance that balances treatment effect and safety frequently results in suboptimal efficacy or coagulation-related adverse events in clinical practice.
A single-center retrospective study was conducted, enrolling 100 patients with MDR-HAP who were assigned to a standard-dose group or a high-dose group based on clinical decisions. The efficacy and safety of different TGC dosing regimens were compared between the two groups.
The trough concentration (C
min
), intermediate concentration (C
1/2
), and peak concentration (C
max
), the estimated ratio of the area under the concentration-time curve to the 24h of dosing/minimum inhibitory concentration (eAUIC), pharmacokinetic/pharmacodynamic (PK/PD) target attainment rate, clinical response rate and overall favorable outcome rate in the high-dose group were significantly higher than those in the standard group (
p
< 0.05). The incidence of thrombocytopenia was significantly higher in the high-dose group (36.67% vs. 17.14%,
p
= 0.034), whereas the incidence of hypofibrinogenemia was numerically higher but did not reach statistical significance (40.0% vs. 30.0%,
p
= 0.330). No significant between-group differences were observed in microbiological eradication rate, median survival time, 30-day all-cause mortality, coagulation parameters, gastrointestinal…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 100 participants or records.
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