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Glycylcycline — MDR Gram-Negative / Polymicrobial / Complicated Intra-abdominal

Tigecycline

Brand names: Tygacil

Tigecycline is a glycylcycline antibacterial reserved for complicated skin and intra-abdominal infections when other antibiotics are unsuitable, with activity against many multidrug-resistant Gram-positive and Gram-negative organisms.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It binds the 30S ribosomal subunit and blocks entry of aminoacyl-tRNA, inhibiting bacterial protein synthesis and overcoming common tetracycline-resistance mechanisms.

Prescribing in practice

  • An observed increase in all-cause mortality means it should be reserved for situations where alternative antibacterials are not suitable.
  • It has poor serum concentrations and is not recommended for bloodstream infections, and it lacks reliable activity against Pseudomonas and Proteus species.
  • As a tetracycline-related drug it should be avoided in pregnancy and in children with developing teeth, and it commonly causes nausea and vomiting.

Monitoring

Monitor clinical response, liver function and for gastrointestinal intolerance during the parenteral course.

Counselling the patient

  • It is given by infusion, usually in hospital under specialist supervision.
  • Nausea and vomiting are common, especially early in treatment.
  • This is a reserve antibiotic used when other options are not appropriate.

Evidence & guidelines

The MHRA and pooled trial analyses have highlighted higher mortality with tigecycline, restricting it to use when alternatives are unsuitable.

Reference: MHRA Drug Safety Update 2013 (Tigecycline Mortality); FDA Safety Communication; IDSA MDR Organism Guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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