Empirical first-line treatment with tigecycline for febrile episodes following abdominal surgery in cancer patients

Giovanni Secondo, Francesca Vassallo, Nicola Solari, Luciano Moresco, Pierluigi Percivale, Lucia Zappi, Ferdinando Cafiero, Andrea De Maria

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Cancer patients with complicated infections following abdominal surgery represent one of the worst clinical scenarios that is useful for testing the efficacy of empirical antimicrobial therapy. No study so far has evaluated the performance of tigecycline (TIG) when administered as empirical first-line treatment in a homogeneous population of surgical cancer patients with a febrile episode. An observational review of the data records of 24 sequential patients receiving TIG for a febrile episode following a major abdominal procedure in a single cancer institute was performed. Large bowel surgery represented 68% of all procedures, followed by gastric surgery (16%) and urinary-gynaecologic-biliary surgery (16%). Complications following surgery were observed in 68% of febrile episodes, with peritonitis and sepsis accounting for 59% and 24% of complications, respectively. Eight patients needed repeat surgery for source control. The mean duration of TIG treatment was 8 days. Causative pathogens were detected in 16 episodes (64%), and a total of 44 microorganisms were recovered (29% Escherichia coli, 9% Enterococcus faecalis and 9% coagulase-negative staphylococci). TIG was effective in 12 episodes (48%). The success rate was 67% when infectious episodes sustained by intrinsically resistant bacteria and fungi were excluded. Treatment failure was associated with the presence of complications and with microbiologically documented infection. TIG may be useful as a first-line treatment option in cancer patients requiring antibiotic treatment following surgery when complications are not present or suspected on clinical grounds and when local microbial epidemiology shows a low incidence of primary resistant bacteria.

Original languageEnglish
Pages (from-to)462-466
Number of pages5
JournalInternational Journal of Antimicrobial Agents
Volume36
Issue number5
DOIs
Publication statusPublished - Nov 2010

Fingerprint

Fever
Neoplasms
Therapeutics
Bacteria
Enterococcus faecalis
Coagulase
Infection
Peritonitis
Treatment Failure
Staphylococcus
Reoperation
tigecycline
Sepsis
Stomach
Epidemiology
Fungi
Escherichia coli
Anti-Bacterial Agents
Incidence
Population

Keywords

  • Cancer
  • Peritonitis
  • Sepsis
  • Tigecycline

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Empirical first-line treatment with tigecycline for febrile episodes following abdominal surgery in cancer patients. / Secondo, Giovanni; Vassallo, Francesca; Solari, Nicola; Moresco, Luciano; Percivale, Pierluigi; Zappi, Lucia; Cafiero, Ferdinando; De Maria, Andrea.

In: International Journal of Antimicrobial Agents, Vol. 36, No. 5, 11.2010, p. 462-466.

Research output: Contribution to journalArticle

Secondo, Giovanni ; Vassallo, Francesca ; Solari, Nicola ; Moresco, Luciano ; Percivale, Pierluigi ; Zappi, Lucia ; Cafiero, Ferdinando ; De Maria, Andrea. / Empirical first-line treatment with tigecycline for febrile episodes following abdominal surgery in cancer patients. In: International Journal of Antimicrobial Agents. 2010 ; Vol. 36, No. 5. pp. 462-466.
@article{44647bbbb8a249aab3f9559c3648e105,
title = "Empirical first-line treatment with tigecycline for febrile episodes following abdominal surgery in cancer patients",
abstract = "Cancer patients with complicated infections following abdominal surgery represent one of the worst clinical scenarios that is useful for testing the efficacy of empirical antimicrobial therapy. No study so far has evaluated the performance of tigecycline (TIG) when administered as empirical first-line treatment in a homogeneous population of surgical cancer patients with a febrile episode. An observational review of the data records of 24 sequential patients receiving TIG for a febrile episode following a major abdominal procedure in a single cancer institute was performed. Large bowel surgery represented 68{\%} of all procedures, followed by gastric surgery (16{\%}) and urinary-gynaecologic-biliary surgery (16{\%}). Complications following surgery were observed in 68{\%} of febrile episodes, with peritonitis and sepsis accounting for 59{\%} and 24{\%} of complications, respectively. Eight patients needed repeat surgery for source control. The mean duration of TIG treatment was 8 days. Causative pathogens were detected in 16 episodes (64{\%}), and a total of 44 microorganisms were recovered (29{\%} Escherichia coli, 9{\%} Enterococcus faecalis and 9{\%} coagulase-negative staphylococci). TIG was effective in 12 episodes (48{\%}). The success rate was 67{\%} when infectious episodes sustained by intrinsically resistant bacteria and fungi were excluded. Treatment failure was associated with the presence of complications and with microbiologically documented infection. TIG may be useful as a first-line treatment option in cancer patients requiring antibiotic treatment following surgery when complications are not present or suspected on clinical grounds and when local microbial epidemiology shows a low incidence of primary resistant bacteria.",
keywords = "Cancer, Peritonitis, Sepsis, Tigecycline",
author = "Giovanni Secondo and Francesca Vassallo and Nicola Solari and Luciano Moresco and Pierluigi Percivale and Lucia Zappi and Ferdinando Cafiero and {De Maria}, Andrea",
year = "2010",
month = "11",
doi = "10.1016/j.ijantimicag.2010.07.019",
language = "English",
volume = "36",
pages = "462--466",
journal = "International Journal of Antimicrobial Agents",
issn = "0924-8579",
publisher = "Elsevier",
number = "5",

}

TY - JOUR

T1 - Empirical first-line treatment with tigecycline for febrile episodes following abdominal surgery in cancer patients

AU - Secondo, Giovanni

AU - Vassallo, Francesca

AU - Solari, Nicola

AU - Moresco, Luciano

AU - Percivale, Pierluigi

AU - Zappi, Lucia

AU - Cafiero, Ferdinando

AU - De Maria, Andrea

PY - 2010/11

Y1 - 2010/11

N2 - Cancer patients with complicated infections following abdominal surgery represent one of the worst clinical scenarios that is useful for testing the efficacy of empirical antimicrobial therapy. No study so far has evaluated the performance of tigecycline (TIG) when administered as empirical first-line treatment in a homogeneous population of surgical cancer patients with a febrile episode. An observational review of the data records of 24 sequential patients receiving TIG for a febrile episode following a major abdominal procedure in a single cancer institute was performed. Large bowel surgery represented 68% of all procedures, followed by gastric surgery (16%) and urinary-gynaecologic-biliary surgery (16%). Complications following surgery were observed in 68% of febrile episodes, with peritonitis and sepsis accounting for 59% and 24% of complications, respectively. Eight patients needed repeat surgery for source control. The mean duration of TIG treatment was 8 days. Causative pathogens were detected in 16 episodes (64%), and a total of 44 microorganisms were recovered (29% Escherichia coli, 9% Enterococcus faecalis and 9% coagulase-negative staphylococci). TIG was effective in 12 episodes (48%). The success rate was 67% when infectious episodes sustained by intrinsically resistant bacteria and fungi were excluded. Treatment failure was associated with the presence of complications and with microbiologically documented infection. TIG may be useful as a first-line treatment option in cancer patients requiring antibiotic treatment following surgery when complications are not present or suspected on clinical grounds and when local microbial epidemiology shows a low incidence of primary resistant bacteria.

AB - Cancer patients with complicated infections following abdominal surgery represent one of the worst clinical scenarios that is useful for testing the efficacy of empirical antimicrobial therapy. No study so far has evaluated the performance of tigecycline (TIG) when administered as empirical first-line treatment in a homogeneous population of surgical cancer patients with a febrile episode. An observational review of the data records of 24 sequential patients receiving TIG for a febrile episode following a major abdominal procedure in a single cancer institute was performed. Large bowel surgery represented 68% of all procedures, followed by gastric surgery (16%) and urinary-gynaecologic-biliary surgery (16%). Complications following surgery were observed in 68% of febrile episodes, with peritonitis and sepsis accounting for 59% and 24% of complications, respectively. Eight patients needed repeat surgery for source control. The mean duration of TIG treatment was 8 days. Causative pathogens were detected in 16 episodes (64%), and a total of 44 microorganisms were recovered (29% Escherichia coli, 9% Enterococcus faecalis and 9% coagulase-negative staphylococci). TIG was effective in 12 episodes (48%). The success rate was 67% when infectious episodes sustained by intrinsically resistant bacteria and fungi were excluded. Treatment failure was associated with the presence of complications and with microbiologically documented infection. TIG may be useful as a first-line treatment option in cancer patients requiring antibiotic treatment following surgery when complications are not present or suspected on clinical grounds and when local microbial epidemiology shows a low incidence of primary resistant bacteria.

KW - Cancer

KW - Peritonitis

KW - Sepsis

KW - Tigecycline

UR - http://www.scopus.com/inward/record.url?scp=77957655864&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77957655864&partnerID=8YFLogxK

U2 - 10.1016/j.ijantimicag.2010.07.019

DO - 10.1016/j.ijantimicag.2010.07.019

M3 - Article

C2 - 20846833

AN - SCOPUS:77957655864

VL - 36

SP - 462

EP - 466

JO - International Journal of Antimicrobial Agents

JF - International Journal of Antimicrobial Agents

SN - 0924-8579

IS - 5

ER -