{
  "abstract": "Evidence for high-dose tigecycline in severe multidrug-resistant Gram-negative infections comes mainly from non-Serratia cohorts. Its value in critically ill adults with resistant Serratia infection is uncertain. PubMed/MEDLINE, CENTRAL, and Consensus were searched up to July 17, 2026. Two evidence sets addressed high-dose tigecycline effectiveness, pharmacokinetics, and safety, and clinical and microbiological evidence for resistant Serratia. Study-level risk ratios were presented without pooling. Searches identified 2,294 records, and 36 studies reported in 37 publications were included. No study reported a verified high-dose regimen in confirmed resistant Serratia infection with a separately extractable organism-specific outcome. Six observational studies used the same high-dose and standard-dose definitions. Fixed 28-day or 30-day mortality risk ratios ranged from 0.34 to 1.30, and all 95% confidence intervals crossed 1.0. Clinical response favored high dose in two studies, with risk ratios of 1.73 (95% confidence interval: 1.22-2.46) and 1.48 (95% confidence interval: 1.08-2.02). Microbiological response favored high dose in two studies, with risk ratios of 1.75 (95% confidence interval: 1.09-2.81) and 1.92 (95% confidence interval: 1.12-3.28). No pooled estimate was calculated. High dose produced a greater fibrinogen decline in one cohort (-3.05 ± 1.67 versus -1.75 ± 1.90 g/L; p=0.038) and more hepatic or platelet abnormalities in another. Direct evidence for high-dose tigecycline in resistant Serratia infection is absent. Indirect studies show possible response benefits without a consistent survival advantage. Treatment decisions should consider infection site, susceptibility, active alternatives, and coagulation risk. By synthesizing both pathogen-specific studies and relevant indirect clinical evidence, this review aimed to provide a more comprehensive assessment of the potential role of high-dose tigecycline in critically ill adults with resistant S. marcescens infections.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Medicine, Command Hospital (Eastern Command), Kolkata, IND.",
    "Department of Critical Care Medicine, Command Hospital (Eastern Command), Kolkata, IND.",
    "Department of Gastroenterology and Hepatology, Command Hospital (Eastern Command), Kolkata, IND."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Arnab Choudhury"
    },
    {
      "affs": [
        0
      ],
      "name": "Ashutosh Chaturvedi"
    },
    {
      "affs": [
        0
      ],
      "name": "Adil Ashraf"
    },
    {
      "affs": [
        2
      ],
      "name": "K V Padmaprakash"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/29vtmpf6x25cp.bib",
  "cited_by": 0,
  "doi": "10.7759/cureus.116890",
  "fulltext_url": "https://europepmc.org/articles/PMC13695843",
  "id": "29vtmpf6x25cp",
  "issns": [
    "2168-8184"
  ],
  "landing_url": "https://europepmc.org/article/MED/42928831",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2736|Antibiotics Pharmacokinetics and Efficacy"
    ]
  ],
  "openalex": "W7214373969",
  "pdf_url": "https://europepmc.org/articles/PMC13695843?pdf=render",
  "pmcid": "PMC13695843",
  "pmid": "42928831",
  "published": "2026-09-25",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/29vtmpf6x25cp.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:18Z",
      "native_id": "MED:42928831",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42928831"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2736|Antibiotics Pharmacokinetics and Efficacy",
      "subfield": "pharmacology-toxicology"
    }
  ],
  "title": "High-Dose Tigecycline for Multidrug-Resistant Serratia Infections in Critically Ill Adults: A Systematic Review of Direct and Indirect Clinical Evidence.",
  "title_text": "High-Dose Tigecycline for Multidrug-Resistant Serratia Infections in Critically Ill Adults: A Systematic Review of Direct and Indirect Clinical Evidence.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:18Z",
  "url": "https://research.draconitic.com/paper/29vtmpf6x25cp",
  "venue": "Cureus",
  "versions": []
}