Abstract

INTRODUCTION

Skin and soft tissue infections (SSTI) are common causes of hospitalization and antibiotic use.They can cause a clinical spectrum ranging from localized inflammation to a life-threatening serious clinical picture such as necrosis accompanied by systemic toxicity. The diagnosis of such infections is usually based on clinical findings and treatment is usually empirically initiated. Tigecycline is a semisynthetic glycylcycline which inhibits protein synthesis by binding to the 30S subunit of the ribosome, thus showing bacteriostatic and bactericidal action. Because of its broad spectrum, it is more frequently preferred in mixed bacterial infections.The aim of this study was to evaluate the clinical and laboratory responses and treatment-related side effects of tigecycline in patients with erysipelas and cellulitis.

METHODS

Patients with the diagnosis of non-purulent cellulitis and erysipelas who were unresponsive to oral antibiotic therapy or who could not be treated orally or required hospitalization were included in the study. The diagnosis was made on physical examination with the presence of at least two of erythema, local warming and induration. Patients with purulent SSTI cases, necrotizing infections and diabetic foot cases were not included in the study.

RESULTS

A total of 30 patients were included in the study. The mean age of the patients was 64 (30-84) years. Twenty-seven patients (90%) had at least one underlying chronic disease. In the samples taken from patients with bullous lesions, meticillin-sensitive Staphylococcus aureus (MSSA), Escherichia coli and Enterococcus faecalis growth were in each patient and simultaneously E.coli and MSSA growth in another patient. Clinical response was obtained in all patients except one patient. Nausea and vomiting were observed in one patient and triglyceride elevation in another patient. When laboratory responses were evaluated after one week of tigecycline treatment, a statistically significant response was revaled in leukocyte counts, sedimentation rates and CRP values.

DISCUSSION AND CONCLUSION

In conclusion, tigecycline was found to be effective and safe in non-purulent moderate to severe cases with cellulite-erysipelas.