Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, China.
Drug Clinical Trial Center, Zhuzhou central hospital, Zhuzhou, China.
J Clin Pharm Ther. 2020 Dec;45(6):1320-1324. doi: 10.1111/jcpt.13212. Epub 2020 Jul 10.
The purpose of this study is to explore the clinical characteristics of tigecycline-induced acute pancreatitis.
We searched the PubMed/Medline, Web of Knowledge, OVID, Elsevier, Springer Link, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Chinese VIP databases from 2005 and identified 19 studies of tigecycline-induced acute pancreatitis involving a total of 22 patients for inclusion in a retrospective analysis.
The median (range) age of 22 patients with acute pancreatitis was 58 years (range 9-83). Overall, the median (range) time of symptom onset was 6.5 days (range 2-28), or 6 days (range 2-14) and 6 days (range 3-28) in patients with or without a loading dose of tigecycline, respectively. Symptoms included nausea, vomiting and abdominal distension (73%) and abdominal pain (73%); 90% (18/20) of patients developed mild acute pancreatitis (MAP), and 10% (2/20) developed severe acute pancreatitis (SAP). Computed tomography (CT) scans showed oedematous infiltrate in 56% (10/18) of cases and acute pancreatitis in 28% (5/18) of cases. The median (range) level of lipase and amylase was 936U/L (range 382-4089) and 588U/L (range 312-1166), respectively. The median (range) time to recovery of symptoms was 4 days (range 1-10), and the time for recovery of pancreatic enzymes to the normal range was 5 days (range 1-30) after the withdrawal of tigecycline in all patients.
Clinicians should be particularly mindful of clinical signs and symptoms, the level of serum pancreatic enzymes and abdominal CT images in order to monitor the development of pancreatitis when using tigecycline.
本研究旨在探讨替加环素引起的急性胰腺炎的临床特征。
我们检索了 PubMed/Medline、Web of Knowledge、OVID、Elsevier、Springer Link、Embase、Cochrane Library、中国知网（CNKI）、万方数据和维普数据库，从 2005 年起确定了 19 项替加环素引起的急性胰腺炎研究，共纳入 22 例患者进行回顾性分析。
22 例急性胰腺炎患者的中位（范围）年龄为 58 岁（范围 9-83）。总体而言，症状发作的中位（范围）时间为 6.5 天（范围 2-28），或无负荷剂量替加环素患者为 6 天（范围 2-14）和有负荷剂量替加环素患者为 6 天（范围 3-28）。症状包括恶心、呕吐和腹胀（73%）和腹痛（73%）；90%（18/20）的患者发生轻度急性胰腺炎（MAP），10%（2/20）发生重度急性胰腺炎（SAP）。计算机断层扫描（CT）扫描显示 56%（10/18）的病例有水肿性浸润，28%（5/18）的病例有急性胰腺炎。中位（范围）血清脂肪酶和淀粉酶水平分别为 936U/L（范围 382-4089）和 588U/L（范围 312-1166）。所有患者的中位（范围）症状缓解时间为 4 天（范围 1-10），替加环素停药后中位（范围）胰腺酶恢复正常范围的时间为 5 天（范围 1-30）。
当使用替加环素时，临床医生应特别注意临床症状和体征、血清胰腺酶水平和腹部 CT 图像，以监测胰腺炎的发生。
