Tigecycline: a novel broad-spectrum antimicrobial

Empiric therapy for intravenous central line infections and nosocomially-acquired acute bacterial endocarditis

Intravascular catheters are essential devices in the intensive care unit, yet catheter-related bloodstream infections (CR-BSI) are associated with increased morbidity and mortality, prolonged hospitalization, and increased medical costs. Management of a CR-BSI requires antibiotics, with or without catheter removal, depending on patient and etiologic factors. Because of the high frequency of staphylococcal infections, it is wise to use a glycopeptide empirically. Extra coverage for Gram-negative bacilli should be administered in severely ill or immunocompromised patients. Once culture and sensitivity results are known, antibiotic therapy can be more selective.

Chemical biology of tetracycline antibioticsThis paper is one of a selection of papers published in this Special Issue, entitled CSBMCB — Systems and Chemical Biology, and has undergone the Journal's usual peer review process

For more than half a century, tetracycline antibiotics have been used to treat infectious disease. However, what once used to be a commonly prescribed family of antibiotics has now decreased in effectiveness due to wide-spread bacterial resistance. The chemical scaffold of the tetracyclines is a versatile and modifiable structure that is able to interact with many cellular targets. The recent availability of detailed molecular interactions between tetracycline and its cellular targets, along with an understanding of the tetracycline biosynthetic pathway, has provided us with a unique opportunity to usher in a new era of rational drug design. Herein we discuss recent findings that have clarified the mode of action and the biosynthetic pathway of tetracyclines and that have shed light on the chemical biology of tetracycline antibiotics.