Ying Song1, Lei Hu1, Qiang Shu2, Jing Ye1, Jianfeng Liang3, Xi Chen4, Linhua Tan5. 1. Department of Surgical ICU, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China. 2. Department of Cardiac Surgery, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China. 3. Department of Medical Statistics, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China. 4. Key Laboratory of Diagnosis and Treatment of Neonatal Diseases of Zhejiang Province, Hangzhou, China; Department of Central Laboratory, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China. 5. Department of Surgical ICU, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China. Electronic address: chtlh@zju.edu.cn.
Abstract
OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of salvage therapy of tigecycline in critically ill children with infections caused by multidrug-resistant (MDR)/extensively drug-resistant (XDR) bacteria after surgery. METHODS: A retrospective chart review was performed of critically ill children after surgery who had received tigecycline for ≥3days between June 2012 and May 2016 in the surgical intensive care unit of a tertiary level children's hospital. RESULTS: Of 6442 consecutive children admitted after surgery, a total of 22 were enrolled. They had a median age of 7.5 months (interquartile range (IQR), 6 months to 4 years) and a median weight of 7.3kg (IQR, 5.1-12.5kg). Patients received tigecycline for a median 17days (IQR, 12-20 days). The median intensive care unit stay was 56days (IQR, 38-61 days) and median hospital stay was 78days (IQR, 61-94 days). Tigecycline was prescribed as culture-directed therapy in 91% of patients and as empirical therapy in 9%. Clinical success was reported in 86% of the patients. The all-cause mortality in this cohort was 18%. No serious adverse effects of tigecycline were detected in these patients. CONCLUSIONS: Tigecycline salvage therapy was successful in 86% of critically ill pediatric patients with MDR/XDR infections after surgery, with no severe adverse effects.
OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of salvage therapy of tigecycline in critically ill children with infections caused by multidrug-resistant (MDR)/extensively drug-resistant (XDR) bacteria after surgery. METHODS: A retrospective chart review was performed of critically ill children after surgery who had received tigecycline for ≥3days between June 2012 and May 2016 in the surgical intensive care unit of a tertiary level children's hospital. RESULTS: Of 6442 consecutive children admitted after surgery, a total of 22 were enrolled. They had a median age of 7.5 months (interquartile range (IQR), 6 months to 4 years) and a median weight of 7.3kg (IQR, 5.1-12.5kg). Patients received tigecycline for a median 17days (IQR, 12-20 days). The median intensive care unit stay was 56days (IQR, 38-61 days) and median hospital stay was 78days (IQR, 61-94 days). Tigecycline was prescribed as culture-directed therapy in 91% of patients and as empirical therapy in 9%. Clinical success was reported in 86% of the patients. The all-cause mortality in this cohort was 18%. No serious adverse effects of tigecycline were detected in these patients. CONCLUSIONS:Tigecycline salvage therapy was successful in 86% of critically ill pediatric patients with MDR/XDR infections after surgery, with no severe adverse effects.