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Case report: tigecycline-induced procalcitonin elevation.

Benben Zhu1, Ting Yang2, Dongsheng Wang3

  • 1Department of Pharmacy, Peking University Cancer Hospital (Inner Mongolia Campus)/Affiliated Cancer Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous Region, 010050, People's Republic of China.

Naunyn-Schmiedeberg'S Archives of Pharmacology
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Summary

Tigecycline can cause elevated procalcitonin (PCT) levels, a rare side effect. Monitoring PCT during tigecycline therapy is crucial to avoid misinterpreting infection status, highlighting the importance of clinical pharmacists.

Keywords:
Adverse drug reactionsPCTTigecycline

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Area of Science:

  • Pharmacology
  • Clinical Medicine
  • Biochemistry

Background:

  • Procalcitonin (PCT) is a biomarker for bacterial infections.
  • Tigecycline is a broad-spectrum antibiotic used for complex infections.
  • Drug-induced alterations in PCT levels can complicate infection assessment.

Purpose of the Study:

  • To report a case of significant procalcitonin elevation caused by tigecycline.
  • To highlight the potential for tigecycline to interfere with PCT interpretation.
  • To emphasize the need for vigilance in monitoring PCT during tigecycline treatment.

Main Methods:

  • Case report of a 76-year-old female patient.
  • Monitoring of procalcitonin (PCT) and C-reactive protein (CRP) levels.
  • Observation of PCT changes in response to tigecycline administration and discontinuation.

Main Results:

  • PCT levels rose significantly from 0.628 ng/mL to 5.944 ng/mL during tigecycline therapy.
  • PCT levels decreased after tigecycline discontinuation and increased upon re-administration.
  • C-reactive protein (CRP) levels remained stable, suggesting PCT elevation was not due to infection worsening.

Conclusions:

  • Tigecycline may induce procalcitonin elevation, a rare adverse drug reaction.
  • Clinicians should consider drug-induced PCT changes to avoid misdiagnosis of infection.
  • This case underscores the role of clinical pharmacists in identifying and managing adverse drug reactions.