Intravenous tigecycline in the treatment of severe recurrent Clostridium difficile colitis

Elaine Y L Cheong and Thomas Gottlieb
Med J Aust 2011; 194 (7): . || doi: 10.5694/j.1326-5377.2011.tb03018.x
Published online: 4 April 2011

To the Editor: Interest in alternative therapies for Clostridium difficile infections (CDIs) is increasing as these infections become important causes of patient morbidity and mortality. Recurrent CDIs can be severe and difficult to treat. In-vitro data,1 followed by reports of the efficacy of tigecycline in the treatment of severe refractory cases of CDI,2 suggest that tigecycline should be considered as an alternative or adjunctive antimicrobial agent in these situations. To date, it has been used mostly as a “salvage” strategy in combination with other antibiotics in the face of clinical deterioration.2,3 We report the successful use of tigecycline monotherapy in the treatment of a patient with recurrent C. difficile colitis.

  • Concord Repatriation General Hospital, Sydney, NSW.

Competing interests:

Thomas Gottlieb is on the advisory boards of Pfizer, Janssen-Cilag and Novartis.

  • 1. Nagy E, Dowzicky MJ. In vitro activity of tigecycline and comparators against European compilation of anaerobes collected as part of the Tigecycline Evaluation and Surveillance Trial (TEST). Scand J Infect Dis 2010; 42: 33-38.
  • 2. Herpers BL, Vlaminckx B, Burkhardt O, et al. Intravenous tigecycline as adjunctive or alternative therapy for severe refractory Clostridium difficile infection. Clin Infect Dis 2009; 48: 1732-1735.
  • 3. Lu CL, Liu CY, Liao CH, et al. Severe and refractory Clostridium difficile infection successfully treated with tigecycline and metronidazole. Int J Antimicrob Agents 2010; 35: 311-312.
  • 4. Johnson S. Recurrent Clostridium difficile infection: a review of risk factors, treatments, and outcomes. J Infect 2009; 58: 403-410.
  • 5. Clements A, Magalhaes RJS, Tatem AJ, et al. Clostridium difficle PCR ribotype 027: assessing the risks of further worldwide spread. Lancet Infect Dis 2010; 10: 395-404.


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