Tigecycline in the management of osteomyelitis: a case series from the bone and joint infection (BAJIO) database

Tigecycline is approved for cutaneous infections, intra-abdominal infections, and community-acquired pneumonia. However, pharmacokinetic data suggest therapeutic concentrations in additional sites, such as bone, despite exiguous clinical data supporting such use. Thus, the objective of this study was to analyze patients with osteomyelitis treated with tigecycline to ascertain its utility in this malady. Our database of osteomyelitis patients was surveyed for instances treated with tigecycline. Cases were evaluated in terms of adverse events and clinical success. Nineteen patients received tigecycline for osteomyelitis. Thirteen met criteria for evaluation of the primary endpoint of clinical success. The most common dose employed was 50 mg twice daily. Adverse events, however, were not statistically more likely with 100 mg administered once daily. Eleven patients (85%) achieved clinical success. Thus, congruent with pharmacokinetic data, tigecycline appeared efficacious for osteomyelitis in the majority of patients who received it. Adverse events were not correlated with dosing strategy.