NB: None for Omadacycline yet, at least in EUCAST.
| Resistance mechanism | Tigecycline | Eravacycline | Omadacycline |
|---|---|---|---|
| Efflux pumps | Little to none |
Enterococcus: MFS pump
Gm negs: RND (AdeABC, AdeFGH, AdeIJK, MexXY, and AcrAB) | Little to none
Reports of MDR efflux pumps | Little to none | | Ribosomal protection protein | Enterococcus: tet(M) | | Little to none | | Drug degradation (Aerobes only) | | | | | rRNA mutation | | Reported | Reported |
| Resistance mechanism | Tigecycline | Eravacycline | Omadacycline |
|---|---|---|---|
| ESBL | Can use, unless BSI/UTI | Can use, unless BSI/UTI | Can use but limited data, Avoid in BSI |
| CRE | Can use, unless BSI/UTI | Can use, unless BSI/UTI | Avoid |
| CRAB | Use in combination | Use if no other option available | Avoid |
| S.maltophilia | Can use, unless UTI | Can use, unless UTI | Avoid |
Tigecycline or eravacycline can be considered as alternative options for intra-abdominal infections, SSTI, osteomyelitis, and respiratory infections
| Item | DoI/link |
|---|---|
| Zhanel GG, Esquivel J, Zelenitsky S, Lawrence CK, Adam HJ, Golden A, et al. Omadacycline: A Novel Oral and Intravenous Aminomethylcycline Antibiotic Agent. Drugs. 2020 Feb;80(3):285–313. | 10.1007/s40265-020-01257-4 |
| Yaghoubi S, Zekiy AO, Krutova M, Gholami M, Kouhsari E, Sholeh M, et al. Tigecycline antibacterial activity, clinical effectiveness, and mechanisms and epidemiology of resistance: narrative review. Eur J Clin Microbiol Infect Dis. 2022;41(7):1003–22. | 10.1007/s10096-020-04121-1 |
| Cai Y, Wang R, Liang B, Bai N, Liu Y. Systematic review and meta-analysis of the effectiveness and safety of tigecycline for treatment of infectious disease. Antimicrob Agents Chemother. 2011 Mar;55(3):1162–72. | 10.1128/AAC.01402-10 |
| Yu WL, Lee NY, Wang JT, Ko WC, Ho CH, Chuang YC. Tigecycline Therapy for Infections Caused by Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Critically Ill Patients. Antibiotics (Basel). 2020 May 5;9(5):231. | 10.3390/antibiotics9050231 |
| Scott LJ. Eravacycline: A Review in Complicated Intra-Abdominal Infections. Drugs. 2019;79(3):315–24. | 10.1007/s40265-019-01067-3 |
| Zhanel GG, Cheung D, Adam H, Zelenitsky S, Golden A, Schweizer F, et al. Review of Eravacycline, a Novel Fluorocycline Antibacterial Agent. Drugs. 2016 Apr;76(5):567–88. | 10.1007/s40265-016-0545-8 |
| Pranita D Tamma, Emily L Heil, Julie Ann Justo, Amy J Mathers, Michael J Satlin, Robert A Bonomo, Infectious Diseases Society of America 2024 Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections, Clinical Infectious Diseases, 2024;, ciae403 | https://doi.org/10.1093/cid/ciae403 |