Efficacy and safety of tigecycline for the treatment of severe infectious diseases: an updated meta-analysis of RCTs

•Firstly, this article showed that tigecycline is less effective than the other antibiotics with significant differences, while the study published before did not show significant statistical differences.•Secondly, we included fifteen randomized control trails of high quality, five of which were newly published.•Thirdly, this article focused on the efficacy and adverse events of tigecycline, while the previous study only looked into one aspect of the two.

SummaryObjectivesTo assess the efficacy and safety of tigecycline in comparison with other antimicrobial treatments for infectious diseases.DesignDatabases of PubMed, Embase and the Cochrane Library were searched through Feb. 2015. The reference lists of the initially identified articles and systemic review articles were manually searched. Randomized controlled trials assessing tigecycline and other antibiotics for infectious diseases in adult patients were included.ResultsFifteen RCTs including 7689 cases were identified. We found that tigecycline was not as effective as the comparator agents for clinical treatment success (for the clinically evaluable population, odds ratio [OR] = 0.83, 95% confidence interval [CI] = (0.73, 0.96), P=0.01; for the clinically modified intent-to-treat (mITT) population, OR = 0.81, 95% CI = (0.72, 0.92), P=0.001). There was no significant difference in microbiological treatment success with lower eradication rate in tigecycline versus comparators (for the microbiologically evaluable population, OR = 0.94, 95% CI = (0.77, 1.16), P=0.56; for the microbiological mITT populations, OR = 0.91, 95% CI = (0.74, 1.11), P=0.35). Adverse events and all-cause mortality were more common in the tigecycline group.ConclusionsTigecycline is not as effective as other antibiotics with relatively more frequency of adverse events and higher mortality rate.