{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T08:36:35Z","timestamp":1775032595634,"version":"3.50.1"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"\n Introduction<\/jats:title>\n Multidrug-resistant (MDR) gram-negative pathogens pose a major therapeutic challenge, particularly in settings with limited antimicrobial options. Tigecycline is frequently used as salvage therapy. However, evidence regarding the optimal tigecycline regimen, whether used as monotherapy or in combination, remains uncertain. This study aimed to describe the characteristics, clinical, and microbiological outcomes of these cases.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Retrospective, single-center study of adult hospitalized patients treated with tigecycline for MDR\n Acinetobacter baumannii<\/jats:italic>\n , extended-spectrum \u03b2-lactamase (ESBL)-producing\n Escherichia coli<\/jats:italic>\n , and ESBL- or Carbapenem-Resistant Enterobacterales\n Klebsiella pneumoniae<\/jats:italic>\n . Patients were categorized into tigecycline monotherapy or combination therapy groups. The primary outcomes were clinical success and 30-day mortality. Multivariable logistic regression was used to identify predictors of outcomes. A sensitivity analysis excluding bloodstream and urinary tract infections was performed due to pharmacokinetic limitations of tigecycline.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Two hundred eighty were included; 116 (41.4%) received tigecycline monotherapy and 164 (58.6%) received combination therapy. Patients receiving combination therapy had higher illness severity and higher intensive care unit admissions. Overall clinical success was achieved in 53.2% of patients with a higher rate in the monotherapy group (64.7%,\n p<\/jats:italic>\n \u00a0=\u00a00.001), and 30-day mortality was 26.1%. After adjustment, tigecycline monotherapy was not independently associated with clinical success or mortality. Sensitivity analyses excluding bloodstream and urinary tract infections showed consistent results.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n In this real-world cohort of severely ill patients with MDR gram-negative infections, no outcome advantage was observed with tigecycline combination therapy after adjustment. Clinical outcomes were primarily driven by illness severity and infection characteristics rather than treatment strategy.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1790441","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T05:42:49Z","timestamp":1775022169000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Characteristics and outcomes of patients treated with tigecycline for MDR gram-negative infections: a retrospective cohort study"],"prefix":"10.3389","volume":"16","author":[{"given":"Shuroug A.","family":"Alowais","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences","place":["Riyadh, Saudi Arabia"]},{"name":"King Abdullah International Medical Research Center","place":["Riyadh, Saudi Arabia"]},{"name":"Ministry of the National Guard - Health Affairs","place":["Riyadh, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atheer","family":"Aldairem","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences","place":["Riyadh, Saudi Arabia"]},{"name":"King Abdullah International Medical Research Center","place":["Riyadh, Saudi Arabia"]},{"name":"Ministry of the National Guard - Health Affairs","place":["Riyadh, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khalid","family":"bin Saleh","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences","place":["Riyadh, Saudi Arabia"]},{"name":"King Abdullah International Medical Research Center","place":["Riyadh, Saudi Arabia"]},{"name":"Ministry of the National Guard - Health Affairs","place":["Riyadh, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yazed S.","family":"Alsowaida","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, University of Ha\u2019il","place":["Ha\u2019il, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhannad Musaad","family":"Alharbi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences","place":["Riyadh, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haytham A.","family":"Wali","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University","place":["Al-Ahsa, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thamer A.","family":"Almangour","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, King Saud University","place":["Riyadh, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"751","DOI":"10.5530\/pj.2024.16.125","article-title":"Prevalence of multidrug resistant organisms (MDROs) and antimicrobial sensitivity pattern from clinical samples of the patients in Riyadh Province of the Kingdom of Saudi Arabia","volume":"16","author":"Alsaab","year":"2024","journal-title":"Pharmacognosy J."},{"key":"B2","doi-asserted-by":"publisher","first-page":"575","DOI":"10.2165\/11317100-000000000-00000","article-title":"Clinical pharmacokinetics and pharmacodynamics of tigecycline","volume":"48","author":"Barbour","year":"2009","journal-title":"Clin. 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