Department of Clinical Pharmacy, Xiangtan Central Hospital, Xiangtan, China.
Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, China.
J Chemother. 2023 Jul;35(4):292-297. doi: 10.1080/1120009X.2022.2105488. Epub 2022 Jul 29.
Knowledge regarding the association between hypofibrinogenemia and tigecycline is based mainly on case reports. However, the clinical features of tigecycline-induced hypofibrinogenemia are unclear. We collected 20 patients (16 males and 4 females) with tigecycline-induced hypofibrinogenemia by searching the Chinese and English databases from June 2005 to May 2021, with a median age of 63.5 years (range 39∼90 years). Hypofibrinogenemia developed at a median of 9 days (range 2∼35 days). Most patients had no typical clinical manifestations, and only a few patients had bleeding and ecchymosis. Fibrinogen levels gradually decreased from 3.98 ± 2.05 g/L to 0.87 ± 0.45 g/L ( = 0.000), and the activated partial thromboplastin time (APTT) increased from 38.26 ± 8.80 s to 83.43 ± 47.23 s ( = 0.002). Fibrinogen levels in all patients recovered to the normal range within a median of 4 days (range 1∼12 days) after tigecycline cessation. Our results suggest that fibrinogen levels should be closely monitored in patients treated with tigecycline, specifically patients who may have renal insufficiency or patients with long-term use.
我们通过检索 2005 年 6 月至 2021 年 5 月的中、英文数据库，收集了 20 例使用替加环素致低纤维蛋白原血症的患者（16 例男性和 4 例女性），其年龄中位数为 63.5 岁（范围为 3990 岁）。低纤维蛋白原血症中位发生时间为 9 天（范围为 235 天）。大多数患者无典型临床表现，仅有少数患者有出血和瘀斑。纤维蛋白原水平逐渐从 3.98±2.05 g/L 下降至 0.87±0.45 g/L（ = 0.000），活化部分凝血活酶时间（APTT）从 38.26±8.80 s 增加至 83.43±47.23 s（ = 0.002）。所有患者在停用替加环素后中位 4 天（范围 1~12 天）内纤维蛋白原水平恢复至正常范围。我们的研究结果提示，在使用替加环素治疗的患者中，特别是可能存在肾功能不全或长期使用者，应密切监测纤维蛋白原水平。
