Observation of tigecycline administration in gram-negative bacteria infected children with ventilator-associated pneumonia

Objective To investigate the efficacy and safety of tigecycline therapy in children with ventilator-associated pneumonia infected by gram-negative bacteria. Methods We conducted a restrospective chart review of children with ventilator-associated pneumonia in a tertiary hospital from May 1, 2012 to April 30, 2017.Inclusion criteria: positive sputum culture result; receiving tigecycline administration of at least 2 days (4 doses). Clinical data and laboratory results were recorded before and after the therapy. Results Twenty-seven children were enrolled, with the in-hospital mortality of 37.0%(10/27). Twenty-seven bacteria strains were recorded, all of which were gram-negative, with Acinetobacter baumanmii took up the most.Most bacteria were susceptible to tigecycline.Median duration of tigecycline was 10 days (3-27 days), 40.7% patients(11/27) got clinically improvement and 44.4%(12/27) got pathogen eradication.Sulperazone was the most concomitantly used antibiotics.Totally 3 dosage models were observed and model 1(loading dose 2 mg/kg, maintain dose 1 mg/kg) and model 2 (loading dose 1.5 mg/kg, maintain dose 1 mg/kg) were the primary.Rate of clinical improvement and microbiology eradication in model 1 group was higher than other groups.No serious adverse effect was detected. Conclusion Tigecycline combined with other agents could be used as salvage therapy in gram-negative bacteria infected ventilator-associated pneumonia children and it is tolerated. Key words: Tigecycline; Ventilator-associated pneumonia; Pediatric intensive care unit; Multidrug resistant; Acinetobacter baumanmii