Among hospitalized patients receiving intravenous (IV) tigecycline, abnormal alanine aminotransferase (ALT) at baseline, intensive care unit (ICU) admission, and treatment duration were independently associated with an increased risk for liver injury, according to findings published in The International Journal of Infectious Diseases.
To assess the prevalence, clinical patterns, and risk factors for tigecycline-induced liver injury, researchers conducted a multicenter retrospective study among hospitalized patients aged 18 years and older who received IV tigecycline for at least 7 days. Risk factors for liver injury were determined via multivariable logistic regression, and the researchers used Roussel Uclaf Causality Assessment Method (RUCAM) scores to determine the likelihood of liver injury due to tigecycline treatment.
Among 397 patients included in the final analysis, the mean age was 64.0 years, 68.3% were men, and tigecycline-induced liver injury occurred in 71 patients, indicating a prevalence of 10.3% (95% CI, 7.51-13.7). Thirty patients were excluded from further analysis due to RUCAM scores of below 6. Of the remaining 41 patients, the mean ALT concentration at baseline was 39.7 U/L, and pulmonary infections were the most common indication for treatment.
Cholestatic was the most common form of liver injury, of which the severity was mild in 85.4% of patients. Multivariable logistic regression analysis showed that abnormal baseline ALT (odds ratio [OR], 3.11; 95% CI, 1.55-6.24; P =.001), ICU admission (OR, 2.63; 95% CI, 1.32-5.36; P =.006), and treatment duration (OR, 1.25; 95% CI, 1.05-1.49; P =.011) were associated with an increased risk for liver injury.
The researchers noted that the maintenance dose of tigecycline was not associated with an increased risk for liver injury in patients who received either standard- or high-dose treatment (50 vs 100 mg twice daily, respectively).
This study was limited by its retrospective design, and the researchers did not assess mortality outcomes.
According to the researchers, “these findings may aid in the clinical application of tigecycline.”
Yu Z, Zhao Y, Jin J, Zhu J, Yu L, Han G. Prevalence and risk factors of tigecycline-induced liver injury: A multicenter retrospective study. Int J Infect Dis. Published online April 14, 2022. doi:10.1016/j.ijid.2022.04.024