Tigecycline Application in a 3-Month-Old Infant with Multiple Drug Resistant Klebsiella Pneumonia: A Case Report

This study presents the first and only case of a child who has survived the process of tigecycline treatment for multiple drug resistant Klebsiella pneumonia. The study discusses the dosage and effects of the antibiotic on the child. The therapeutic schedule and its safety for patients above 3 months old are also explored.

Running head: GRAPHICAL ABSTRACT AND TIMELINE
GRAPHICAL ABSTRACT AND TIMELINE
Name of the Student
Name of the University
Authors Note:

1GRAPHICAL ABSTRACT AND TIMELINE
Key of terms:
Hirschsprung’s disease : Large intestine affecting
disease
Meropenem, Tigecycline : Type of antibiotic
Intravenous : administered into the vein Subcutaneous : Situated under skin
Small intestinal atresia
and Hirschsprung’s
disease
Started breastfeeding
(intravenous nutrition)
6 days
Severe malnutrition
and absence of
subcutaneous fat
Colonoscopy was
performed
3 months
Bacterial diarrhea
Recovered in 1 week
with he treatment of
Meropenem
18 months
Rotavirus diarrhea and
severe dehydration
Intravenous fluid therapy
recieved and recovered
32 months
Grew deciduous teeth
Weight 14 Kg
Height 90 cm
34 months
Height 90 cm
grew complete deciduous
teeth; no discoloration
First and only case for the
use of Tigecycline sucessfully
in child
36 months
Citation: Peng, C., Wang, X., Zhang, J., Jiang, Y. and Hou, X., 2018.
Tigecycline application in a 3-month-old infant with multiple drug resistant
Klebsiella pneumonia: a case report. Gut Pathogens, 10(1), p.25.
enterectomy and
an ileostomy
antiseptic-impregnated
CNC with habitane,
sulfadiazine and
tigecyclin

2GRAPHICAL ABSTRACT AND TIMELINE
Summary:
The antibiotic tigecycline is known as the ‘immature’ antibiotic for the children. This is
called immature because it had earlier not been tested on children and the dosage and other aspects
of the drug were not known. This study presented the first and only case of a child who has
survived the process of the tigecycline treatment. Till the age of 3 years, no significant negative
effects have been observed in the patient. The case study presented in this article concerned with
the condition of a 3-month-old infant who was undergoing a catheter-associated bloodstream
infection caused by the multiple drugs resistant bacteria Klebsiella pneumonia which is a bacteria
that is responsible for the nosocomial infections. The antibiotic Tigecycline was considered to be
the best option of therapy for the purpose of controlling the severe sepsis occurred as a result of the
disease condition. The therapy undertaken consisted of 3 mg/kg as a loading dose and 1.5 mg/kg
Q12 h as a maintenance dose for 26 days. The loading dose is an initial higher dose of a particular
drug which can be given at the beginning of a course of treatment before dropping down to a lower
maintenance dose. On the other hand, the maintenance dose refers to the maintenance rate of a
particular drug administration which is equal to the rate of elimination at steady state.
Therefore, it was deduced that tigecycline acts as the rescuer in case of severe infections
although it is considered still to be immature for the children. As a result, the pediatricians find it
difficult to judge the appropriate dosage of administration for the children. It has also been
concluded from the study that this therapeutic schedule might be safe for the patients who are only
above 3 months old and further investigation is needed in this particular field. This study also
concluded this was the first case where Tigecycline antibiotic was used on the child and the
disease was cured. In future there will be other studies conducted where the dosage could be
imitated however the effects of antibiotic along with its side effects will be monitored.

3GRAPHICAL ABSTRACT AND TIMELINE
Keywords: Tigecycline, Klebsiella pneumoniae, Hirschsprung’s disease, Pediatric, Multiple drug
resistant bacteria

4GRAPHICAL ABSTRACT AND TIMELINE
Bibliography:
Peng, C., Wang, X., Zhang, J., Jiang, Y. and Hou, X., 2018. Tigecycline application in a 3-month-
old infant with multiple drug resistant Klebsiella pneumonia: a case report. Gut Pathogens, 10(1),
p.25.