Systematic review of the influential factors for the clinical efficacy of tigecycline in treatment of severe infections caused by MDR-GNB
- VernacularTitle:替加环素对MDR-GNB重症感染患者疗效影响因素的系统评价
- Author:
Mei DU
1
;
Hejun CHEN
1
;
Yanan DU
2
;
Xiaoyan ZHANG
1
;
Ruijuan TAN
1
Author Information
1. Dept. of Pharmacy，Hengshui People’s Hospital，Hebei Hengshui 053000，China
2. Dept. of ICU，the Second People’s Hospital of Hengshui，Hebei Hengshui 053000，China
- Publication Type:Journal Article
- Keywords:
tigecycline;
multidrug-resistant Gram-negative
- From:
China Pharmacy
2025;36(23):2990-2994
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To systematically evaluate the influential factors for the clinical efficacy of tigecycline in the treatment of severe infections caused by multidrug-resistant Gram-negative bacteria （MDR-GNB）. METHODS Retrieved from PubMed， Embase， The Cochrane Library， CNKI database， Wanfang database and VIP database， the studies about the influential factors for the clinical efficacy of tigecycline in the treatment of adult patients with severe infections caused by MDR-GNB from the database construction to April 30， 2025. After screening literature， extracting data and evaluating the quality of literature， systematic review was performed by using RevMan 5.3 software. RESULTS A total of 14 studies involving 2 033 patients were included， of which 1 355 patients showed effective treatment outcomes. The meta-analysis results showed that Acute Physiology and Chronic Health Evaluation （APACHE）-Ⅱ ＞ 20 [OR＝4.50， 95%CI （2.28， 8.85）， P＜0.001]， malignant tumor [OR＝1.96， 95%CI （1.41， 2.72）， P＜0.001]， hemodialysis [OR＝2.09， 95%CI （1.40， 3.12）， P＜0.001]， septic shock [OR＝3.07， 95%CI （2.00， 4.72）， P＜0.001]， mechanical ventilation [OR＝2.31， 95%CI （1.57， 3.39）， P＜0.001]， coagulation dysfunction [OR＝ 3.03， 95%CI （2.09， 4.37）， P＜0.001]， glucocorticoids use＞3 days [OR＝2.26， 95%CI （1.14， 4.45）， P＝0.020]， and longer hospitalization time before using tigecycline [OR＝3.33， 95%CI （1.34， 8.30）， P＝0.010] were risk factors for the clinical efficacy of tigecycline in treatment of severe infections caused by MDR-GNB. Tigecycline initial double-dose regimen [OR＝0.23， 95%CI （0.13， 0.42）， P＜0.001]， combination therapy [OR＝0.15， 95%CI （0.05， 0.48）， P＝0.001]， and prolonged treatment course [OR＝0.91， 95%CI （0.88， 0.95）， P＜0.001] were protective factors. CONCLUSIONS There are many influential factors for the clinical efficacy of tigecycline in the treatment of severe infections caused by MDR-GNB， among which APACHE-Ⅱ score＞20， malignant tumor， hemodialysis， septic shock， mechanical ventilation， coagulation dysfunction， glucocorticoids＞3 d and longer hospitalization time before using tigecycline before tigecycline （No.20251606） use are risk factors； tigecycline double dose， combined medication and longer treatment course are protective factors.
