Tigecycline

Hello @payette78, There have been a few members that have mentioned Tigecycline. Here is a search link that lists the discussions and comments by members if you want to scan through them while you wait for others to respond - https://connect.mayoclinic.org/search/?search=Tigecycline.

Thanks. I did the search before i posted the question. The posts with tigecycline were mostly from 2021 so i was hoping for some more recent input

I understand your nervousness. When I was diagnosed, I refused azithromycin and was treated with another drug instead because of past reactions to prescribed Z-packs. Wow, it turned out the alternative (lost in the sludge of my memory) was worse - so we tried slowly introducing the azithromycin and I tolerated it. And when I had Pseudomonas, it took two tries to get a drug I could tolerate.

Why did I tell this story? To let you know that sometimes antibiotic therapy, especially for our lung infections, is often a two-steps-forward-one-step-back proposition. You may well have to work with your doctor to see what you can take. If they are at all familiar with treating MAC (I think you might have M Abscessus) they are also accustomed to having to try/adjust/try again.

Tigecycline is a strong antibiotic, so side effects are more common, Some of the effects that we get can be managed (nausea, diarrhea, stomach pain) and may lessen as the body gets used to them. Others may be a "no go" and you will have to change. Here is a review of the drug:
https://www.drugs.com/sfx/tigecycline-side-effects.html
The usual side effects do affect a about 1/3 of people, and you will be encouraged to try to get through them, as unpleasant as that sounds. If the result is getting rid of the infection, it is worth it. Familiarize yourself with the potential serious side effects (less than 10% of patients get them) and let your care team know right away.

Will you be doing this in hospital, at an infusion center, or at home?

I understand your nervousness. When I was diagnosed, I refused azithromycin and was treated with another drug instead because of past reactions to prescribed Z-packs. Wow, it turned out the alternative (lost in the sludge of my memory) was worse - so we tried slowly introducing the azithromycin and I tolerated it. And when I had Pseudomonas, it took two tries to get a drug I could tolerate.

Why did I tell this story? To let you know that sometimes antibiotic therapy, especially for our lung infections, is often a two-steps-forward-one-step-back proposition. You may well have to work with your doctor to see what you can take. If they are at all familiar with treating MAC (I think you might have M Abscessus) they are also accustomed to having to try/adjust/try again.

Tigecycline is a strong antibiotic, so side effects are more common, Some of the effects that we get can be managed (nausea, diarrhea, stomach pain) and may lessen as the body gets used to them. Others may be a "no go" and you will have to change. Here is a review of the drug:
https://www.drugs.com/sfx/tigecycline-side-effects.html
The usual side effects do affect a about 1/3 of people, and you will be encouraged to try to get through them, as unpleasant as that sounds. If the result is getting rid of the infection, it is worth it. Familiarize yourself with the potential serious side effects (less than 10% of patients get them) and let your care team know right away.

Will you be doing this in hospital, at an infusion center, or at home?

Nuzyra has less side effects than tigicycline and is also in the tetracycline family. It's a new drug and expensive, but I hear most insurance companies will cover it. Maybe something to ask your doctor about. I'm taking Nuzyra, Linezolid, and Arikayce for M. Abscessus. I started taking it at 10PM due to fasting requirements, but did experience insomnia, so now take it early in the morning-and no side effects. The fasting cannot eat anything 4 hours before dose and 2 hours after. Just a thought.

The original plan was for a PICC line and home infusions but that was before only 3 drugs tested susceptible. The treatment plan hasn't been finalized and i am considering refusing treatmen5, so just wondering how bad it can get and whether there is hope of sailing through relatively unscathed. Thanks for the lengthy reply. All the input really helps and it is gratifying to know there are people out there who care enough tovtake the time and effort.

I did the PICC line and home infusions for abscessus sp. massilience in early 2024. The tigecycline gave me N&V buy I truly believe it is why I converted in two months along with the amikacin and impenimum. 25mg of promethazine handled the N&V while the Zofran did not.
I would NOT be afraid on the tigecycline.