The authors performed a systematic review of the literature identifying patients with MDR Gram-negative bacillus UTIs treated with tigecycline. Fourteen cases describing treatment of UTIs caused by MDR Gram-negative bacilli with tigecycline are reviewed. Favourable clinical outcomes were noted in 11 of 14 cases. An initial favourable microbiological outcome was noted in 12 cases. Post-treatment cultures in two cases were positive for tigecyclineresistant organisms.
As 16-22% of the drug is excreted unchanged in urine, high doses (eg 200 mg daily) may inhibit urinary isolates. Based on the available literature, tigecycline appears to have efficacy in some patients with MDR Gram-negative bacillus UTIs, especially as other options such as amikacin or colistin may be nephrotoxic.