NAPLEX Practice Question # 20

NAPLEX Examination:

Daily Practice question # 20.

Tigecycline (Tygacil).  Naplex Review

An intravenous glycylcycline antibiotic developed as a semisynthetic analogue of tetracycline with a broad spectrum of activity.

• Mechanism of action. Tigecycline is bacteriostatic; it inhibits bacterial protein synthesis by reversibly binding to the 30S ribosome subunit.
• Spectrum of activity. Th e drug is active against vancomycin-susceptible E. faecalis, methicillin-resistant S. epidermidis, and S. aureus (methicillin-susceptible and –resistant strains) as well as some gram-negative aerobes and anaerobes.
• Th erapeutic uses. Tigecycline is indicated for the treatment of complicated intra-abdominal infections caused by E. coli, vancomycin-susceptible E. faecalis, S. aureus (methicillinsusceptible strains only) and B. fragilis. Also indicated for the treatment of complicated skin and skin structure infections caused by E. faecalis (vancomycin-susceptible strains), S. pyogenes and S. aureus (methicillin-susceptible and -resistant strains).

Precautions and monitoring effects

• Safety data are limited. Side eff ects are generally mild with GI disturbances—for example, nausea (22% to 35%) and vomiting (13% to 19%)—the most commonly reported. Th e mechanism of these reactions is uncertain.
• May cause permanent discoloration of the teeth similar to the tetracyclines.
• Caution in patients with a history of hypersensitivity reactions to tetracyclines.
• Phototoxic reactions, pancreatitis, and increases in BUN may occur.