{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:04:05Z","timestamp":1789535045864,"version":"build-2803163510"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"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":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dosing tigecycline, an important last resort for carbapenem-resistant organisms, should be under the guidance of pharmacokinetic\/pharmacodynamic (PK\/PD) theory. However, tigecycline has shown large interindividual variability in PK among different patients, and its PK\/PD target has limited data support. This study aimed to evaluate the clinical outcome and the relationship with exposure in critically ill patients with drug-resistant infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single center, prospective observational, single-arm cohort study was performed to assess the outcome and its relationship with exposure in critically ill patients with drug-resistant pathogen infections. Patients were enrolled according to the inclusion and exclusion criteria. The clinical outcomes, including clinical response rate, 28-day mortality rate, and major adverse events (AEs), were followed up. Plasma concentrations in steady status were intensively collected and determined for tigecycline concentration, and the 24-hour area-under-curves (AUCs) were calculated. The exposure-clinical outcome relationship was analyzed, and multivariate logistic regressions were performed to identify risk factors that associated with outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 130 patients were included. The most common infection type was low respiratory tract infection (76\/130), and carbapenem-resistant\n                      <jats:italic>Acinetobacter baumannii<\/jats:italic>\n                      was the most common pathogen (64\/130). The median tigecycline treatment length was 12 days. The median AUC was 14.0 mg h\/L. The overall response rate and 28-day mortality rate were 50.0% and 36.2%, respectively. A lower fibrinogen level was the most common AE (51\/130). ALB, PLT and combined use of cefoperazone-sulbactam were independent factors associated with clinical response, but AUC was negatively associated with clinical response.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The clinical outcome of tigecycline in critically ill patients with resistant pathogen infection was satisfactory, but negative relationship between tigecycline exposure and outcome was found and the PK\/PD profile in these patients should be revisited.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1868760","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T04:29:14Z","timestamp":1789532954000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical outcomes and their relationship with tigecycline exposure in critically ill patients with drug resistant infections"],"prefix":"10.3389","volume":"16","author":[{"given":"Wei","family":"Su","sequence":"first","affiliation":[{"name":"Intensive Care Unit, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuping","family":"Song","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Tang","sequence":"additional","affiliation":[{"name":"Research Center for Clinical Pharmacy, Zhejiang University","place":["Hangzhou, China"]},{"name":"Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binbin","family":"Feng","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinshan","family":"Wu","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haitao","family":"Yu","sequence":"additional","affiliation":[{"name":"Clinical Lab, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Guo","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenwei","family":"Yu","sequence":"additional","affiliation":[{"name":"Research Center for Clinical Pharmacy, Zhejiang University","place":["Hangzhou, China"]},{"name":"Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1080\/1040841X.2024.2313024","article-title":"Antibiotic resistance: a global crisis, problems and solutions","volume":"50","author":"Aggarwal","year":"2024","journal-title":"Crit. 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