METHODS: We performed a retrospective analysis of patients who received tigecycline for more than 3 days between January 2015 and June 2019. Clinical and laboratory data were collected including fibrinogen concertation, tigecycline dose, duration of treatment, disease severity, complete blood count, indicators of infection, liver and renal function. Risk factors of hypofibrinogenemia were analyzed by univariate and multivariate analysis. To evaluate the safety of tigecycline and concomitant antithrombotic drugs, bleeding events were assessed by comparing the decline in hemoglobin and the amount of red blood cell transfusion in patients with antithrombotic drugs and those without.
RESULTS: This study included a total of 68 cases, 20 of which experienced hypofibrinogenemia while receiving tigecycline treatment. Duration of treatment, cefoperazone/sulbactam combination therapy, and fibrinogen levels prior to initiation of tigecycline were risk factors associated with tigecycline-induced hypofibrinogenemia. There were 26 recorded bleeding incidents, 25 of which happened before the start of tigecycline. Antithrombotic and non-antithrombotic patients did not differ in their hemoglobin decline or need for red blood cell transfusions while taking tigecycline.
CONCLUSIONS: A longer treatment duration, cefoperazone/sulbactam combination therapy, and a lower level of fibrinogen before tigecycline were associated with an increased risk of tigecycline-induced hypofibrinogenemia. A combination of antithrombotic drugs and tigecycline did not aggravate the bleeding events during tigecycline treatment.
方法:我们对2015年1月至2019年6月期间接受替加环素超过3天的患者进行了回顾性分析。收集临床和实验室数据,包括纤维蛋白原浓度,替加环素剂量,治疗持续时间,疾病严重程度,全血细胞计数,感染的指标,肝肾功能。采用单因素和多因素分析低纤维蛋白原血症的危险因素。评估替加环素和联合抗血栓药物的安全性,通过比较使用抗血栓药物的患者和未使用抗血栓药物的患者的血红蛋白下降和红细胞输注量来评估出血事件.
结果:本研究共纳入68例,其中20例在接受替加环素治疗时出现低纤维蛋白原血症。治疗持续时间,头孢哌酮/舒巴坦联合治疗,替加环素开始前的纤维蛋白原水平是替加环素诱导的低纤维蛋白原血症的相关危险因素。记录了26起出血事件,其中25次发生在替加环素开始之前。抗血栓和非抗血栓患者在服用替加环素时,血红蛋白下降或需要输注红细胞没有差异。
结论:治疗持续时间较长,头孢哌酮/舒巴坦联合治疗,替加环素前纤维蛋白原水平较低与替加环素诱导的低纤维蛋白原血症风险增加相关。在替加环素治疗期间,抗血栓药物和替加环素的组合并未加重出血事件。