Tigecycline-associated hypofibrinogenemia in a real-world setting.

Area of Science:

• Pharmacology
• Clinical Medicine
• Hematology

Background:

• Tigecycline is a broad-spectrum antibiotic for resistant infections, often requiring high doses and extended durations.
• Adverse events associated with tigecycline may be more frequent and severe than reported in clinical trials.
• Case reports suggest a link between tigecycline use and hypofibrinogenemia.

Purpose of the Study:

• To investigate the effect of tigecycline on coagulation parameters.
• To identify risk factors associated with tigecycline-induced hypofibrinogenemia.

Main Methods:

• Observational, retrospective study of adult patients receiving tigecycline for over 72 hours.
• Collected and analyzed clinical and laboratory data, including fibrinogen and INR, before, during, and after tigecycline treatment.
• Used paired-sample Student's t-test and binary logistic regression to analyze data and identify risk factors.

Main Results:

• Tigecycline significantly decreased plasma fibrinogen (mean decrease 1.76 g/L) and increased INR (mean increase 0.11).
• Hypofibrinogenemia occurred in 12 patients, with 5 bleeding events requiring intervention.
• Independent risk factors for fibrinogen decrease included treatment duration over 4 weeks, high-dose tigecycline, and high protein C levels.

Conclusions:

• Tigecycline administration is associated with hypofibrinogenemia, particularly with high-dose regimens.
• Healthcare professionals should monitor coagulation parameters during tigecycline treatment, especially in patients receiving high doses.
• Awareness of potential tigecycline-associated hypofibrinogenemia is essential for patient safety.