Tigecycline-induced coagulopathy: a literature review

作者：Nannan Cui, Hongliu Cai, Zhitao Li, Yuting Lu, Guobin Wang, Anwei Lu · 发表于：International Journal of Clinical Pharmacy · 年份：2019 · DOI：10.1007/s11096-019-00912-5 · 被引用次数：56 · 研究领域：Antibiotics Pharmacokinetics and Efficacy、Methemoglobinemia and Tumor Lysis Syndrome、Drug-Induced Adverse Reactions

Background Several adverse reactions to tigecycline, which is widely used in patients with severe infections, have been documented. Coagulopathy is a lesser known side effect of tigecycline. Aim of the review We summarize the characteristics, possible mechanisms, and treatment of tigecycline-induced coagulopathy. Method PubMed, Ovid, Embase, ISI Web of Knowledge, CNKI, and Wanfang were searched up to March 5, 2019. All articles concerning coagulopathy induced by tigecycline were included. The article types and languages were not limited. The retrieved articles were screened by two experienced clinicians by reading the titles, abstracts, and full texts. Results Ultimately, 17 articles were targeted, including 13 case reports and 4 retrospective observational studies. Tigecycline-induced coagulopathy usually manifests as the dose-dependent prolongation of prothrombin time and activated partial thromboplastin time and a reduction in the fibrinogen level. Tigecycline and its metabolites may have multiple effects on coagulation, influencing the extrinsic or intrinsic pathway and even the common pathway. There is no specific treatment for tigecycline-induced coagulopathy, but it can be reversed by withdrawing tigecycline. Conclusion Tigecycline acts on the coagulation system in a dose-dependent manner, and the most severe adverse event is bleeding. Overdose and prolonged use should be avoided, suspected coagulopathy must be recognized in time, and tigecycline should be withdrawn to...