Purpose: To investigate tigecycline prescription and patient outcomes in the Kingdom of Saudi Arabia
(KSA).
Methods: A retrospective observational study was conducted in three KSA government hospitals,
between January, 2013 and May, 2014. The patients were identified from electronic prescription
records; data were retrieved by trained researchers.
Results: Thirty-seven patients who received tigecycline were included (mean age, 52.5 years; range,
17 92); 51.4 % were female. Tigecycline was prescribed for sepsis (59.5 %), pneumonia (21.6 %),
and/or intra-abdominal infections (13.5 %). The majority of the patients (86.5 %) were prescribed
tigecycline in intensive care unit (ICU) and the remaining patients were in the general medical ward.
APCHE II score at the beginning of treatment was 16.8 ± 4.3, indicating severe disease. Susceptibility
testing revealed 22 different bacterial pathogens, most commonly
Acinetobacter baumannii
(20 patients)
and
Klebsiella pneumoniae
(14 patients). A significant proportion (56.7 %) was polymicrobial and 16.2
% involved suspected resistant pathogens. Sixteen patients recovered (5 on tigecycline alone, 5 with
additional antimicrobials, and six switched to alternatives) while 21 patients died (nine on tigecycline
alone, 12 with additional antimicrobials).
Conclusions: The study revealed that tigecycline prescription was conducted according to marketing
authorizations and national guidelines. Infection severity/stage and comorbidities may influence
patients’ response, and explain some of the poor outcomes.
