Comparison of bleeding risk and hypofibrinogenemia-associated risk factors between tigecycline with cefoperazone/sulbactam therapy and other tigecycline-based combination therapies
Background: Tigecycline and cefoperazone/sulbactam can cause coagulation disorders; tigecycline may also lead to hypofibrinogenemia, raising safety concerns. This study aimed to investigate whether tigecycline plus cefoperazone/sulbactam increases the risk of bleeding compared with other tigecycline...
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2023.1182644/full |
| _version_ | 1827382885804408832 |
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| author | Lei Zhang Xinfeng Cai Fangchen Peng Shuangshuang Tian Xinjing Wu Yun Li Jinlin Guo |
| author_facet | Lei Zhang Xinfeng Cai Fangchen Peng Shuangshuang Tian Xinjing Wu Yun Li Jinlin Guo |
| author_sort | Lei Zhang |
| collection | DOAJ |
| description | Background: Tigecycline and cefoperazone/sulbactam can cause coagulation disorders; tigecycline may also lead to hypofibrinogenemia, raising safety concerns. This study aimed to investigate whether tigecycline plus cefoperazone/sulbactam increases the risk of bleeding compared with other tigecycline-based combination therapies and identify risk factors for tigecycline-associated hypofibrinogenemia.Methods: In this multi-method, multicenter, retrospective study, coagulation and other baseline variables were compared using a cohort study, and risk factors for hypofibrinogenemia using a case-control study.Results: The 451 enrolled participants were divided into three group: tigecycline plus cefoperazone/sulbactam (Group A, 193 patients), tigecycline plus carbapenems (Group B, 200 patients) and tigecycline plus β-lactams without N-methylthio-tetrazole (NMTT) side chains (Group C, 58 patients). Activated partial thromboplastin time and prothrombin time were prolonged, and fibrinogen declined for all patients after tigecycline-based medication (all p < 0.05). Prothrombin time in Group B was significantly longer than in other groups (p < 0.05), but there were no significant differences in bleeding events between the three groups (p = 0.845). Age greater than 80 years (OR: 2.85, 95% CI: 1.07–7.60), treatment duration (OR: 1.29, 95% CI: 1.19–1.41), daily dose (OR: 2.6, 95% CI: 1.29–5.25), total bilirubin (OR: 1.01, 95% CI: 1.01–1.02) and basal fibrinogen (OR: 1.32, 95% CI: 1.14–1.63) were independent risk factors of hypofibrinogenemia. The optimal cut-off for treatment course was 6 days for high-dose and 11 days for low-dose.Conclusion: Tigecycline plus cefoperazone/sulbactam did not increase the risk of bleeding compared with tigecycline plus carbapenem, or tigecycline plus β-lactam antibiotics without NMTT-side-chains. Coagulation function should be closely monitored in patients receiving tigecycline treatment. |
| first_indexed | 2024-03-08T14:27:53Z |
| format | Article |
| id | doaj.art-37f6453b6bef4fb4bdb4286f24e20227 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-03-08T14:27:53Z |
| publishDate | 2023-06-01 |
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| series | Frontiers in Pharmacology |
| spelling | doaj.art-37f6453b6bef4fb4bdb4286f24e202272024-01-12T16:33:55ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122023-06-011410.3389/fphar.2023.11826441182644Comparison of bleeding risk and hypofibrinogenemia-associated risk factors between tigecycline with cefoperazone/sulbactam therapy and other tigecycline-based combination therapiesLei Zhang0Xinfeng Cai1Fangchen Peng2Shuangshuang Tian3Xinjing Wu4Yun Li5Jinlin Guo6Department of Pharmacy, Shanxi Provincial People’s Hospital, Taiyuan, ChinaDepartment of Pharmacy, Shanxi Province Cancer Hospital, Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, ChinaDepartment of Pharmacy, Shanxi Provincial People’s Hospital, Taiyuan, ChinaDepartment of Nephrology, Shanxi Provincial People’s Hospital, Taiyuan, ChinaDepartment of Pharmacy, Yuncheng Central Hospital, Yuncheng, ChinaDepartment of Pharmacy, Shanxi Provincial People’s Hospital, Taiyuan, ChinaDepartment of Pharmacy, Shanxi Provincial People’s Hospital, Taiyuan, ChinaBackground: Tigecycline and cefoperazone/sulbactam can cause coagulation disorders; tigecycline may also lead to hypofibrinogenemia, raising safety concerns. This study aimed to investigate whether tigecycline plus cefoperazone/sulbactam increases the risk of bleeding compared with other tigecycline-based combination therapies and identify risk factors for tigecycline-associated hypofibrinogenemia.Methods: In this multi-method, multicenter, retrospective study, coagulation and other baseline variables were compared using a cohort study, and risk factors for hypofibrinogenemia using a case-control study.Results: The 451 enrolled participants were divided into three group: tigecycline plus cefoperazone/sulbactam (Group A, 193 patients), tigecycline plus carbapenems (Group B, 200 patients) and tigecycline plus β-lactams without N-methylthio-tetrazole (NMTT) side chains (Group C, 58 patients). Activated partial thromboplastin time and prothrombin time were prolonged, and fibrinogen declined for all patients after tigecycline-based medication (all p < 0.05). Prothrombin time in Group B was significantly longer than in other groups (p < 0.05), but there were no significant differences in bleeding events between the three groups (p = 0.845). Age greater than 80 years (OR: 2.85, 95% CI: 1.07–7.60), treatment duration (OR: 1.29, 95% CI: 1.19–1.41), daily dose (OR: 2.6, 95% CI: 1.29–5.25), total bilirubin (OR: 1.01, 95% CI: 1.01–1.02) and basal fibrinogen (OR: 1.32, 95% CI: 1.14–1.63) were independent risk factors of hypofibrinogenemia. The optimal cut-off for treatment course was 6 days for high-dose and 11 days for low-dose.Conclusion: Tigecycline plus cefoperazone/sulbactam did not increase the risk of bleeding compared with tigecycline plus carbapenem, or tigecycline plus β-lactam antibiotics without NMTT-side-chains. Coagulation function should be closely monitored in patients receiving tigecycline treatment.https://www.frontiersin.org/articles/10.3389/fphar.2023.1182644/fulltigecyclinecefoperazone/sulbactamcarbapenemsβ-lactam antibioticscoagulation disordershypofibrinogenaemia |
| spellingShingle | Lei Zhang Xinfeng Cai Fangchen Peng Shuangshuang Tian Xinjing Wu Yun Li Jinlin Guo Comparison of bleeding risk and hypofibrinogenemia-associated risk factors between tigecycline with cefoperazone/sulbactam therapy and other tigecycline-based combination therapies Frontiers in Pharmacology tigecycline cefoperazone/sulbactam carbapenems β-lactam antibiotics coagulation disorders hypofibrinogenaemia |
| title | Comparison of bleeding risk and hypofibrinogenemia-associated risk factors between tigecycline with cefoperazone/sulbactam therapy and other tigecycline-based combination therapies |
| title_full | Comparison of bleeding risk and hypofibrinogenemia-associated risk factors between tigecycline with cefoperazone/sulbactam therapy and other tigecycline-based combination therapies |
| title_fullStr | Comparison of bleeding risk and hypofibrinogenemia-associated risk factors between tigecycline with cefoperazone/sulbactam therapy and other tigecycline-based combination therapies |
| title_full_unstemmed | Comparison of bleeding risk and hypofibrinogenemia-associated risk factors between tigecycline with cefoperazone/sulbactam therapy and other tigecycline-based combination therapies |
| title_short | Comparison of bleeding risk and hypofibrinogenemia-associated risk factors between tigecycline with cefoperazone/sulbactam therapy and other tigecycline-based combination therapies |
| title_sort | comparison of bleeding risk and hypofibrinogenemia associated risk factors between tigecycline with cefoperazone sulbactam therapy and other tigecycline based combination therapies |
| topic | tigecycline cefoperazone/sulbactam carbapenems β-lactam antibiotics coagulation disorders hypofibrinogenaemia |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2023.1182644/full |
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