Tigecycline Versus Colistin in the Treatment of Carbapenem-resistant Acinetobacter baumannii Complex Osteomyelitis.

Autor:	Oliveira PR; Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil., Carvalho VC; Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil., Saconi ES; Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil., Leonhardt MC; Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil., Kojima KE; Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil., Santos JS; Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil., Rossi F; Laboratorio de Microbiologia DLC, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil., Lima ALLM; Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil.
Jazyk:	angličtina
Zdroj:	Journal of bone and joint infection [J Bone Jt Infect] 2020 Feb 21; Vol. 5 (2), pp. 60-66. Date of Electronic Publication: 2020 Feb 21 (Print Publication: 2020).
DOI:	10.7150/jbji.42448
Abstrakt:	Background : Acinetobacter baumannii complex is an increasingly important cause of osteomyelitis. It is considered a difficult to treat agent, due to increasing antimicrobial resistance and few available therapeutic options. Objective : To compare effectiveness and tolerability of tigecycline and colistin in patients with osteomyelitis caused by carbapenem-resistant A. baumannii complex (CRABC). Methods : This retrospective review included all patients admitted to a 150-bed tertiary hospital from 2007 to 2015 with microbiologically confirmed CRABC osteomyelitis for which they received tigecycline or colistin. Data on demographic and clinical characteristics, adverse events, and outcomes 12 months after the end of antimicrobial treatment were analysed and stratified according to the antimicrobial used. Results : 65 patients were included, 34 treated with colistin and 31 with tigecycline. There were significantly more men ( P = 0.028) in the colistin group, and more smokers ( P = 0.021) and greater occurrence of chronic osteomyelitis ( P = 0.036) in the tigecycline treatment group. Median duration of therapy was 42.5 days for colistin and 42 days for tigecycline, with no significant difference. Overall incidence of adverse events was higher in the colistin group ( P = 0.047). In particular, incidence of renal impairment was also higher in this group ( P = 0.003). Nausea and vomiting were more frequent with tigecycline ( P = 0.046). There were no significant differences between groups in relapse, amputation, or death. Conclusions : Tigecycline had a better safety profile than colistin in the treatment of osteomyelitis due to CRABC, with no significant difference in outcomes after 12 months of follow-up. Competing Interests: Competing Interests: P.R. Oliveira and A.L. Lima have received funds for research and for speaking at symposia organized on behalf of Pfizer. V.C. Carvalho and E.S. Saconi have received funds for research from Pfizer. F. Rossi has received funds for speaking at symposia organized on behalf of Pfizer. All other authors have nothing to declare. (© The author(s).)
Databáze:	MEDLINE
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