Kopterides P, Papageorgiou C, Antoniadou A, Papadomichelakis E, Tsangaris I, Dimopoulou I, Armaganidis A
2nd Critical Care Department, Attiko University Hospital, School ofMedicine, University ofAthens, Athens, Greece.
Anaesth Intensive Care. 2010 Jul;38(4):755-8. doi: 10.1177/0310057X1003800339.
Clostridium difficile infection is an emerging and often difficult-to-treat iatrogenic complication. Recent data suggest that tigecycline, a novel antibiotic with broad-spectrum antibacterial activity, can be used successfully to treat patients with severe Clostridium difficile infection. We report a 70-year-old man who developed severe Clostridium difficile infection, was admitted to the intensive care unit and eventually succumbed to complications of his illness despite receiving tigecycline for approximately three weeks in combination with vancomycin, metronidazole and intravenous immunoglobulin. Additionally, we discuss the unique challenges that emerged during tigecycline treatment, such as the development of Proteus mirabilis bacteraemia and of colonisation with Acinetobacter baumannii resistant to tigecycline. Finally, we review data on other cases reported in the medical literature. Even though tigecycline looks promising for the treatment of Clostridium difficile infection, we urge caution against its indiscriminate use for off label indications.
艰难梭菌感染是一种新出现且往往难以治疗的医源性并发症。近期数据表明，替加环素这种具有广谱抗菌活性的新型抗生素可成功用于治疗重症艰难梭菌感染患者。我们报告了一名70岁男性，他发生了重症艰难梭菌感染，入住重症监护病房，尽管接受了约三周的替加环素治疗，并联合使用了万古霉素、甲硝唑和静脉注射免疫球蛋白，但最终仍死于疾病并发症。此外，我们讨论了替加环素治疗期间出现的独特挑战，如奇异变形杆菌菌血症的发生以及对替加环素耐药的鲍曼不动杆菌定植。最后，我们回顾了医学文献中报道的其他病例的数据。尽管替加环素在治疗艰难梭菌感染方面看起来很有前景，但我们敦促谨慎对待其用于非标签适应症的滥用情况。
