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We have read with great interest papers published concerning the efficacy and safety of tigecycline and the ensuing correspondence. Mortality has been reported in most of the publications to be higher with tigecycline in comparison with other antimicrobial agents. However, we would like to make some remarks on the role of superinfection rates during treatment with tigecycline, and the impact on safety. Tigecycline was approved by the US FDA for the treatment of complicated skin and skin structure infections and complicated intra-abdominal infections (2005), and for community-acquired pneumonia (2009). Due to the high rates of multidrug-resistant (MDR) pathogens and the scarcity of new antibacterial agents, the use of tigecycline was extended to the treatment of colistin-resistant Acinetobacter baumannii infections, and as an alternative for patients allergic to β-lactam antimicrobial agents, by the Commission of Infections and Antimicrobial Policy in our hospital.The Ministerio de Ciencia e Innovación, Instituto de Salud Carlos III co-financed by the European Development Regional Fund ‘A way to achieve Europe’ ERDF, Spanish Network for Research in Infectious Diseases (REIPI RD06/0008) supported this work.Peer Reviewe

More about the safety of tigecycline for the treatment of infectious diseases: the role of superinfection rates