Correspondence
Wenjuan Fan, MD, Department of Gastroenterology, Tongji Hospital, Tongji
Medical College, Huazhong University of Science and Technology, No. 1095
Jiefang Avenue, Wuhan 430030, Hubei, China. e-mail:
juanwenfan1989@163.com.
Aims: To analyze the clinical characteristics and risk factors
for tigecycline-induced pancreatitis (TIP) and evaluate the safety and
efficiency of tigecycline use in non-TIP.
Methods: A retrospective case-control study was conducted on
adult and juvenile patients administered tigecycline for >3
days. The adults were classified as TIP, non-TIP (pancreatitis with
other causes), and non-pancreatitis. Univariate analyses were performed
to compare TIP and non-pancreatitis, and multivariate analysis was used
to identify risk factors for TIP. The clinical characteristics of TIP
and the safety and efficiency of tigecycline use in non-TIP were
evaluated.
Results: A total of 3910 patients (3823 adults and 87
juveniles) were enrolled. The adult patients comprised 21 TIP, 82
non-TIP, and 3720 non-pancreatitis. The TIP prevalences were 0.56% in
adults and 1.15% in juveniles. The mean time from tigecycline use to
symptom onset was 7.2 days, and all cases were mild pancreatitis. The
mean time from tigecycline withdrawal to symptom relief was 3.6 days.
The multivariate analysis identified comorbid renal insufficiency as an
independent risk factor for TIP (odds ratio = 3.032). Among the 82
non-TIP patients, 81.7% had severe pancreatitis and 47.6% had
necrotizing pancreatitis. The modified computed tomography severity
score after tigecycline use was similar to that before tigecycline use,
but the pancreatic enzymes and infection indices were significantly
decreased.
Conclusion: The prevalence of TIP was low. Comorbid renal
insufficiency was as an independent risk factor for TIP. Tigecycline is
safe and efficient for treatment of pancreatitis, especially necrotizing
pancreatitis, with intra-abdominal infection.
KEYWORDS
tigecycline, acute pancreatitis, side effect; risk factor; safety.
Abbreviations: ALP, alkaline
phosphatase; AP, acute pancreatitis; APTT, activated partial
thromboplastin time; CT, computed tomography; ERCP, endoscopic
retrograde cholangiopancreatography; IQR, interquartile range; MDR,
multidrug-resistant; OR, odds ratio; PT, prothrombin time; SD, standard
deviation; TIP, tigecycline-induced pancreatitis; XDR, extensively
drug-resistant.