Clinical beta
FMBM is currently in clinical beta. Content is for professional review/testing and must not replace local protocols, senior clinical judgment, or official prescribing references.
Drug Monograph
Tigecycline
Glycylcycline (IV)
Indication
Complicated intra-abd β’ SSTI β’ CAP (selected) β’ MDR pathogens last-line
INDICATIONS (CORE USE)
Broad IV for resistant polymicrobial / MDR situations β **FDA mortality warning meta-analysis** β avoid empiric monotherapy for serious infection when alternatives exist; **nausea** common; **not renally dosed**.
ADULT DOSE (STANDARD)
100 mg IV load then 50 mg IV q12h
MAX DOSE
50 mg q12h after load (adult)
Route
IV
PEDIATRIC DOSE
Pediatric use very restricted β specialist
Must-not-miss safety points
Major warning
- **Mortality signal** in some meta-analyses vs comparators β reserve for appropriate cases; combination therapy often preferred - **Bacteriostatic** β caution monotherapy in bacteremia (especially pneumonia) - Pancreatitis - Tooth/bone deposition pediatric β avoid young kids
USE IF: Complicated SSTI / intra-abd / CAP when resistant organisms or beta-lactam allergy pathways per ID. AVOID IF: Primary bacteremia monotherapy when better bactericidal options; trivial infection.
Primary
Secondary
Other
STANDARD (ADULT PO)
100 mg load β 50 mg q12h
ADULT DOSE
100 mg IV Γ1 then 50 mg IV q12h over 30β60 min
PEDIATRIC DOSE
Not routine β specialist protocols.
MAX DOSE
50 mg q12h maintenance
Practical Note
Hepatic Child-Pugh C β dose adjustment per label.
Clinical warnings
Adverse effects
Pediatrics
Pediatric use very restricted β specialist
Pregnancy
Animal fetal toxicity β avoid unless no alternative
Lactation
unknown.
Renal impairment
No adjustment; not removed by dialysis significantly β clinical effect persists. **CrCl scaffold (FMBM β titrate to FDA/SFDA label + institutional pharmacy nomogram):** - **CrCl β₯50** β no CrCl adjustment for elimination - **CrCl 10β50** β no CrCl adjustment - **CrCl <10** β no CrCl adjustment; Child-Pugh C hepatic β dose reduction per label
Hepatic impairment
Severe hepatic impairment β reduce dose per label.
Elderly
Mortality confounders β clinical judgment.
IV infusion; antiemetic PRN.
Clinical Picture
**Life-threatening (first):** **shock** / **severe pancreatitis** (rare). **Secondary:** nausea/vomiting.
Immediate Actions
Stop infusion β antiemetics; lipase if abdominal pain
Antidote
No specific antidote; treat complications (e.g. anaphylaxis β epinephrine per ACLS)
Decontamination
N/A
Escalation
Severe pancreatitis, shock β **ICU**
Common mistakes, resistance logic, and bedside traps
Broad MDR rescue drug β **black box mortality discussion** in literature. **Not for UTI** (urine penetration poor). **Bacteriostatic** β think twice in sick bacteremia.
Combine with other active agents in CRE/MDR regimens per ID. Antiemesis planning improves completion. Black box: document informed indication. *Stewardship (all antimicrobials):* Empiric choice β syndrome severity + **local antibiogram**; shortest effective course.
Large Vd; hepatic clearance; penetrates tissues well; poor urine levels β **not for UTI**.
Glycylcycline β 30S ribosome inhibition; broader than tetracyclines.
Global data (no country-specific data available)
Saudi Arabia
(placeholder β verify local formulary)
Common trade names are curated examples only β formulations and availability vary. Verify the exact product name with your local pharmacy and national regulator before prescribing or dispensing.
Saudi Arabia
International