Tigecycline Dosing in Neonates with Acinetobacter Sepsis

Current Recommendations and Limitations

• The American Academy of Pediatrics and other medical societies recommend that tigecycline has no established dosing recommendations for neonates according to current guidelines 1, 2
• The use of tigecycline is explicitly not recommended in patients under 18 years of age unless no alternative antimicrobial agents are available, as stated by the Infectious Diseases Society of America 1, 2
• Pediatric infectious diseases specialist consultation is strongly advised prior to considering tigecycline use in any pediatric patient, as recommended by the Pediatric Infectious Diseases Society 2

Alternative First-Line Options for Acinetobacter Sepsis in Neonates

• For neonates with Acinetobacter sepsis, the American Academy of Pediatrics recommends considering meropenem as an alternative, with dosing as follows:
• The Infectious Diseases Society of America also recommends imipenem as an alternative, with dosing as follows:
• For multidrug-resistant strains, the Society for Healthcare Epidemiology of America recommends colistin, with a dose of 2.5-5 mg CBA/kg/day IV in 2 or 4 divided doses 1

Tigecycline Use in Older Children (If Absolutely Necessary)

• If all alternatives have been exhausted and tigecycline must be considered for older children, the American Academy of Pediatrics recommends the following dosing:

Important Considerations and Cautions

• Tigecycline achieves low plasma concentrations, making it suboptimal for bloodstream infections, as noted by the Infectious Diseases Society of America 3
• Combination therapy is generally preferred over tigecycline monotherapy for multidrug-resistant organisms, as recommended by the Society for Healthcare Epidemiology of America 3
• Infectious disease consultation is highly recommended for management of infections caused by multidrug-resistant organisms, as stated by the Pediatric Infectious Diseases Society 2