Risk factors analysis of hypofibrinogenemia associated with tigecycline

Abstract Purpose: This aim of this study was to analyze the effect of tigecycline on blood coagulation parameters and identify which variables may be related with it. Patients and methods: This is a retrospective and observational study conducted in a tertiary general hospital in China. All patients over 18 years old, who received tigecycline for >48 hours were included. After treatment with tigecycline, patients were divided into two groups according to fibrinogen plasma concentration< 2.0 g/L. Data of patients were collected. Multivariate logistic regression was performed to identify risk factors for hypofbrinogenemia associated with tigecycline. Results: 50 patients (71.3 ±20.2 years) were analyzed. The median duration of treatment was 8 days (3～20). 24 patients develoed hypofibrinogenemia, 3 gastrointestinal bleeding events were observed and 4 of them required fibrinogen administration. We identified the cumulative dose (OR =15.28, IC 95% 2.10-111.02, p = 0.01) and the baseline direct bilirubin >0.4mg/dL (OR =5.79, IC 95% 1.13-27.98, p = 0.04) as risk factors for tigecycline induced hypofibrinogenemia, while the baseline fibrinogen (OR =0.53, IC95% 0.29-0.97, p = 0.04) was likely a protective factor. Conclusions:Tigecycline administration may be related with hypofibrinogenemia. Medical workers should realize that the use of tigecycline may induce hypofibrinogenemia or even serious adverse reactions, and monitor the coagulation routine during treatment, especially when the cumulative dose of tigecycline was greater or liver dysfunction especially direct bilirubin abnormality.