Eravacycline infusion-related hypoesthesia: A case report

Area of Science:

• Infectious Diseases
• Pharmacology
• Clinical Neurology

Background:

• Eravacycline (ERV) is a crucial antibiotic for treating drug-resistant Gram-negative bacteria and nontuberculous mycobacteria (NTM).
• Infusion site reactions are a known potential adverse effect of ERV therapy.
• Nontuberculous mycobacteria (NTM) infections are increasingly challenging to treat, necessitating effective antibiotic options like ERV.

Observation:

• A 74-year-old male patient developed severe hypoesthesia (numbness and tingling) during ERV infusion for Mycobacterium chelonae pneumonia.
• Symptoms of hypoesthesia, including peripheral paresthesia and oral numbness, emerged shortly after initiating ERV infusion.
• The patient experienced recurrent hypoesthesia upon re-administration of ERV, even with an extended infusion time, leading to drug discontinuation.

Findings:

• The Naranjo scale confirmed a definite adverse drug reaction (ADR) to ERV, with a score of 9.
• A review of FDA data identified 22 ERV-associated events, with 18% linked to infusion-related reactions.
• Published Phase 3 clinical trial data did not report hypoesthesia as an adverse event associated with ERV.

Implications:

• This case represents a unique instance of severe hypoesthesia directly linked to ERV infusion.
• Further investigation is required to understand the correlation between ERV concentration, dosage, infusion duration, and the occurrence of hypoesthesia.
• Developing effective mitigation strategies for ERV-induced infusion reactions is essential for patient safety and continued therapeutic use.