Tigecycline-associated hypofibrinogenemia: A single center, retrospective, controlled study

Area of Science:

• Pharmacology
• Clinical Medicine
• Hematology

Background:

• Tigecycline is associated with hypofibrinogenemia, a significant adverse effect requiring further investigation.
• Controlled studies are needed to minimize confounding factors in assessing tigecycline's impact on fibrinogen.

Purpose of the Study:

• To assess changes in fibrinogen levels during hospitalization comparing tigecycline and other antibiotic treatments within the same patients.
• To compare bleeding events, bleeding risk, and mortality rates between tigecycline and other antibiotic periods.

Main Methods:

• Retrospective, self-controlled case series study conducted at university hospitals.
• Comparison of fibrinogen levels, bleeding events, IMPROVE bleeding risk score, and 15- and 30-day mortality rates between tigecycline (TigePer) and other antibiotic (OtherPer) periods.
• Enrolled 50 patients with 100 antibiotic treatment episodes.

Main Results:

• Tigecycline treatment (TigePer) showed a statistically significant reduction in fibrinogen levels compared to OtherPer (p < 0.001).
• Hypofibrinogenemia occurred in 40% of TigePer episodes versus 2% in OtherPer (p < 0.001).
• Tigecycline was associated with a significantly higher 15-day mortality rate (p = 0.006), but no significant differences in bleeding risk or 30-day mortality were observed.

Conclusions:

• Hypofibrinogenemia and coagulopathies are more frequent with tigecycline use, often without associated bleeding.
• Clinicians must monitor fibrinogen levels closely during tigecycline therapy.
• Tigecycline use requires careful consideration due to potential hematological and mortality risks.