Tigecycline for the treatment of patients with Clostridium difficile infection: an update of the clinical evidence

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Clostridium difficile infection (CDI) is the most common cause of nosocomial diarrhea in adult patients and is associated with considerable morbidity and mortality. Apart from the standard treatment regimens, tigecycline has shown significant in vitro activity against C. difficile but data regarding its clinical impact remains controversial. The aim of this article is to update the evidence related to the clinical role of tigecycline against C. difficile.


PubMed and Scopus databases were searched for relevant literature published from January 2015 to July 2018.


Six retrospective cohort studies, 1 prospective study, 1 case series, and 2 case reports provided data regarding the effectiveness of tigecycline against C. difficile and were included in our evaluation. Also, we performed a meta-analysis based on 186 patients (from 4 studies) that showed clinical cure 79% (95% CI 73.0–84.5%).


Despite the heterogeneity of the included studies and the small number of patients, the available evidence suggests that tigecycline might be considered as a potential therapeutic option for patients with CDIs, especially in severe cases.

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Fig. 1
Fig. 2



Clostridium difficile infection


European Society of Clinical Microbiology and Infectious Diseases


Infectious Diseases Society of America


Not reported


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Correspondence to Matthew E. Falagas.

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Conflict of interest

MEF participated in advisory boards of AstraZeneca, InfectoPharm, Tetraphase, Shionogi, and Xellia; received lecture honoraria from Cipla, Merck, and Pfizer; and received research support from Shionogi, Tetraphase, Helperby, and Xellia. The other authors have no conflicts of interest.

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Kechagias, K.S., Chorepsima, S., Triarides, N.A. et al. Tigecycline for the treatment of patients with Clostridium difficile infection: an update of the clinical evidence. Eur J Clin Microbiol Infect Dis (2020).

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  • Tigecycline
  • Clostridium difficile
  • Severe infection
  • Glycylcyclines