Tigecycline Induced Fibrinogen Decrease in Critically Ill Patients with Multidrug Resistant Bacterial Infections - an Observational Retrospective Study

Abstract A decrease of plasma fibrinogen level has occasionally been observed during tigecycline treatment. The present observational retrospective study was performed to analyze the effect of tigecycline on coagulation function in critically ill patients with multidrug-resistant bacterial infections, especially on plasma fibrinogen level. 83 adult subjects treating with tigecycline were enrolled. Coagulation function spanning all three time periods (berore, during and after tigecycline administration) was determined to measure the effects of tigecycline. A striking decrease of fibrinogen was noted during tigecycline treatment (P=0.000), and this change started to reverse when tigecycline was stopped. In the higher-dose group, fibrinogen also dropped significantly during tigecycline treatment (P=0.009), and after the cessation of tigecycline, the fibrinogen level did not rebound, but kept on drop. The fibrinogen levels dropped significantly in the 4 patients developed new-onset bleeding during tigecycline treatment, showing almost simultaneously. There were increased prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), platelet count (PLT) and decreased platelet level during tigecycline treatment and a reversal when tigecycline was stopped, although only the difference of PT reached significance (P=0.043). Tigecycline induced fibrinogen decrease in critically ill patients with multidrug-resistant bacterial infections, and this change started to reverse when tigecycline was stopped.