Clinical characteristics and risk factors for tigecycline-induced pancreatitis in a tertiary hospital: a retrospective study

Abstract

Background and Purpose: Information on tigecycline-induced pancreatitis (TIP) is lacking in real-world settings. We aim to analyze the clinical characteristics and risk factors for TIP and evaluate the safety and efficiency of tigecycline use in non-TIP. Experimental Approach: A retrospective case-control study was conducted on adult and juvenile patients administered tigecycline for >3 days. Adults were classified as TIP, non-TIP (pancreatitis with other causes), and non-pancreatitis. Univariate analyses were performed to compare TIP and non-pancreatitis, multivariate analysis was used to identify risk factors for TIP. The clinical characteristics of TIP and the safety and efficiency of tigecycline use in non-TIP were evaluated. Key results: A total of 3910 patients (3823 adults and 87 juveniles) were enrolled. The adults comprised 21 TIP, 82 non-TIP, and 3720 non-pancreatitis. TIP prevalences were 0.56% in adults and 1.15% in juveniles. The mean time from tigecycline use to symptom onset was 7.2 days (were mild pancreatitis). The mean time from tigecycline withdrawal to symptom relief was 3.6 days. Comorbid renal insufficiency was an independent risk factor for TIP (OR = 3.032). Among the 82 non-TIP patients, 81.7% had severe pancreatitis and 47.6% had necrotizing pancreatitis. The modified computed tomography severity score after tigecycline use was similar to that before use, but the pancreatic enzymes and infection indices were significantly decreased. Conclusions and Implications: The prevalence of TIP was low. Comorbid renal insufficiency was as an independent risk factor for TIP. Tigecycline is safe and efficient for treatment of pancreatitis, especially necrotizing pancreatitis, with intra-abdominal infection.