Preliminary Experience of Tigecycline Treatment for Infection in Children with Hematologic Malignancies

Background Severe infection is life-threatening in children with hematologic malignancies and its treatment is challenging because of an increasing number of multidrug-resistant pathogens. Tigecycline has an expanded antibacterial activity spectrum; some successful cases of tigecycline treatment have been reported in the literature. Objective To examine the efficacy and safety of tigecycline in children. Setting Department of hematologic malignancies in a tertiary hospital. Method A retrospective chart review from May 1, 2012 to May 1, 2017. The patients were identified by the hospital information system and a custom-made Microsoft Excel 2007 database of patients was created to record demographic and medical data. Main outcome measure Efficacy and safety of tigecycline use in severe infection children with hematologic malignancies. Results Thirty-seven patients were enrolled and the predominant diagnosis was acute lymphoblastic leukemia. The median duration of tigecycline therapy was 9 days. Most prescriptions were empirical. Eighteen patients received a maintenance dose of 2 mg/kg q12 h, without a loading dose. Sulperazone was the most frequently prescribed concomitant drug. At the end of tigecycline therapy, improvement was observed in 48.7% of cases. After treatment, interleukin-10 levels notably decreased. The only reported adverse event was a case of tooth discoloration. Conclusion Tigecycline can be used as salvage therapy in children with hematologic malignancy and seems tolerable. Prospective controlled studies are required to definitively evaluate the efficacy and safety of tigecycline in children.