• Type: Glycylcycline (Tetracyclines)
  • Dosage Forms: IV
  • Common Trade Names: Tygacil

Adult Dosing

Intra-Abdominal Infections

  • 50mg IV q12h x5-14 days
    • Start: 100mg IV x1

Skin Infections, complicated

  • 50mg IV q12h x5-14 days
    • Start: 100mg IV x1

Pneumonia, Community acquired

  • 50mg IV q12h for at least 5 days
    • Start 100mg IV x1
    • May D/C after 5 days if afebrile 48-72h

Pediatric Dosing

Intra-abdominal Infections

  • 8-11yo
    • 1.2 mg/kg IV q12h
    • Max: 50 mg/12h
  • 12-17 yo
    • 50mg IV 112h

Skin Infections, complicated

  • 8-11yo
    • 1.2 mg/kg IV q12h
    • Max: 50 mg/12h
  • 12-17 yo
    • 50mg IV 112h

Pneumonia, Community Acquired

  • 8-11yo
    • 1.2 mg/kg IV q12h
    • Max: 50 mg/12h
  • 12-17 yo
    • 50mg IV 112h

Special Populations

  • Drug rating in pregnancy: D
  • Lactation risk category: Possibly Unsafe; consider alternatives
  • Renal Dosing
    • Adult: No adjustment
    • Pediatric: No adjustment
  • Hepatic Dosing
    • Adult:
      • Child-Pugh Class C: Decrease maintenance dose 50%
    • Pediatric:
      • Not defined, but may be required. See adult dosing.


  • Allergy to class/drug
  • Pregnancy
  • Age <8 years
  • Hospital-acquired pneumonia
  • Diabetic foot infection
  • Caution:
    • Child bearing potential
    • Hepatic impairment

Adverse Reactions


  • Tooth discoloration children <8 years old
  • Photosensitivity
  • Hypersensitivity reaction
  • Skin reaction
  • Vasculitis
  • Pericarditis
  • Autoimmune hepatitis
  • Hepatotoxicity
  • Nephrotoxicity
  • Esophagitis/ulcer
  • Pancreatitis
  • Thrombocytopenia
  • Neutropenia
  • Hemolytic anemia
  • Pseudotumor cerebri
  • Bulging fontanelles
  • Jarisch-Herxheimer reaction
  • Fetal harm


  • Headache
  • Nausea
  • Dyspepsia
  • Arthralgia
  • Diarrhea
  • Rash
  • Dysmenorrhea
  • Photosensitivity
  • Vulvovaginal candidiasis
  • Skin discoloration
  • Elevated BUN


  • Half-life: Unknown
  • Metabolism: Minimal
  • Excretion: Bile/feces - 59%; Urine 33%
  • Mechanism of Action: Bacteriostatic

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram PositiveStrep. Group A, B, C, GS
Strep. PneumoniaeS
Viridans strepX1
Strep. anginosus gpX1
Enterococcus faecalisS
Enterococcus faeciumS
Staph. EpidermidisS
C. jeikeiumS
L. monocytogenesS
Gram NegativesN. gonorrhoeaeX2
N. meningitidisX1
Moraxella catarrhalisS
H. influenzaeS
E. coliS
Klebsiella spS
E. coli/Klebsiella ESBL+S
E coli/Klebsiella KPC+S
Enterobacter sp, AmpC negS
Enterobacter sp, AmpC posS
Serratia spX1
Serratia marcescensS
Salmonella spS
Shigella spS
Proteus mirabilisX1
Proteus vulgarisI
Providencia sp.X1
Morganella sp.X1
Citrobacter freundiiX1
Citrobacter diversusX1
Citrobacter sp.X1
Aeromonas spX1
Acinetobacter sp.I
Pseudomonas aeruginosaR
Burkholderia cepaciaI
Stenotrophomonas maltophiliaS
Yersinia enterocoliticaX1
Francisella tularensisX1
Brucella sp.X1
Legionella sp.X2
Pasteurella multocidaX1
Haemophilus ducreyiX1
Vibrio vulnificusX1
MiscChlamydophila spS
Mycoplasm pneumoniaeS
Rickettsia spX1
Mycobacterium aviumR
Bacteroides fragilisS
Prevotella melaninogenicaS
Clostridium difficileX1
Clostridium (not difficile)S
Fusobacterium necrophorumS
Peptostreptococcus sp.S


  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also


  1. Sanford Guide to Antimicrobial Therapy 2014
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