As part of the Tigecycline Evaluation and Surveillance Trial (TEST), Gram-negative and Gram-positive organisms were collected from 31 medical centres in nine countries in the Asia-Pacific Rim between 2004 and 2007. Overall, 34.2% of Acinetobacter spp. were multidrug-resistant, and 17.0% of Klebsiella pneumoniae and 10.6% of Escherichia coli produced extended-spectrum beta-lactamases. A total of 39.5% of Staphylococcus aureus were meticillin-resistant and 21.7% of Enterococcus faecium were vancomycin-resistant. Tigecycline MIC(90) values (minimum inhibitory concentration for 90% of the organisms) were <or=2mg/L against Acinetobacter spp., K. pneumoniae, E. coli, Enterobacter spp. and Serratia marcescens and <or=0.25mg/L against S. aureus, E. faecalis and Enterococcus faecium. Antimicrobial resistance is widespread in the Asia-Pacific Rim. Tigecycline has excellent in vitro activity against a broad spectrum of bacteria, including resistant strains.