The pharmaceutical care of a multidrug-resistant bacterial infection patient with tigecycline-induced hypofibrinogenemia

LI Jie; ZHU Deqiu

doi:10.6039/j.issn.1001-0408.2023.08.22

您当前的位置：

首页 >

文章列表页 >

The pharmaceutical care of a multidrug-resistant bacterial infection patient with tigecycline-induced hypofibrinogenemia

更新时间：2023-04-25

- The pharmaceutical care of a multidrug-resistant bacterial infection patient with tigecycline-induced hypofibrinogenemia
- ZHONGGUO YAOFANG Vol. 34, Issue 8, Pages: 1010-1013(2023)
- 作者机构：
  
  同济大学附属同济医院药剂科，上海　200065
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2023.08.22
  CLC： R969.3;R978
- Published：30 April 2023，
  
  Received：31 August 2022，
  
  Revised：03 March 2023，
扫描看全文
李洁,祝德秋.替加环素致多重耐药菌感染患者低纤维蛋白原血症的药学监护 ^Δ[J].中国药房,2023,34(08):1010-1013.

LI Jie,ZHU Deqiu.The pharmaceutical care of a multidrug-resistant bacterial infection patient with tigecycline-induced hypofibrinogenemia[J].ZHONGGUO YAOFANG,2023,34(08):1010-1013.
李洁,祝德秋.替加环素致多重耐药菌感染患者低纤维蛋白原血症的药学监护 ^Δ[J].中国药房,2023,34(08):1010-1013. DOI： 10.6039/j.issn.1001-0408.2023.08.22.

LI Jie,ZHU Deqiu.The pharmaceutical care of a multidrug-resistant bacterial infection patient with tigecycline-induced hypofibrinogenemia[J].ZHONGGUO YAOFANG,2023,34(08):1010-1013. DOI： 10.6039/j.issn.1001-0408.2023.08.22.

摘要

目的

为临床治疗多重耐药菌感染患者使用替加环素致低纤维蛋白原血症的药学监护和替加环素的安全使用提供参考。

方法

临床药师通过参与1例多重耐药菌感染患者使用替加环素致低纤维蛋白原血症的案例，对替加环素与低纤维蛋白原血症不良反应的相关性进行判断，并结合相关文献分析替加环素致低纤维蛋白原血症发生的危险因素和可能机制；建议医师停用替加环素，并给予人纤维蛋白原和血浆纠正。

结果与结论

替加环素与患者的低纤维蛋白原血症有关。医师采纳临床药师意见，患者纤维蛋白原水平恢复至正常水平。替加环素致低纤维蛋白原血症发生的危险因素包括大剂量、长疗程用药，以及患者自身合并肾功能不全。临床药师及时给予医师停药建议，并建议在必要时输注人纤维蛋白原和血液制品进行纠正，避免了严重且危及生命的凝血障碍的发生，保障了替加环素使用的安全性。

Abstract

OBJECTIVE

To provide reference for pharmaceutical care of multidrug-resistant bacterial infection patients with tigecycline-induced hypofibrinogenemia and the safe use of tigecycline.

METHODS

Clinical pharmacists participated in a case of hypofibrinogenemia caused by tigecycline with multidrug-resistant bacterial infection， to determine the correlation of hypofibrinogenemia and tigecycline， and to analyze the risk factors and possible mechanisms of the occurrence of hypofibrinogenemia caused by tigecycline in combination with relevant literature. Clinical pharmacists recommended that physicians discontinued tigecycline and provided human fibrinogen and plasma for correction.

RESULTS & CONCLUSIONS

Tigecycline was associated with hypofibrinogenemia of the patient. The physician followed the advice of clinical pharmacists and the patient’s fibrinogen level returned to normal. The risk factors of hypofibrinogenemia induced by tigecycline included high dose， long course of treatment， and complication with renal dysfunction. Clinical pharmacists should timely advise physicians to stop taking the drug， and give human fibrinogen and blood product infusion for correction when necessary， so as to avoid the occurrence of serious life-threatening coagulation disorders and ensure the safety of tigecycline use.

关键词

替加环素多重耐药感染药学监护低纤维蛋白原血症

Keywords

pharmaceutical carehypofibrinogenemiamultidrug-resistant bacterial infection

references

《抗菌药物临床应用指导原则》修订工作组. 抗菌药物临床应用指导原则：2015年版[M]. 北京：人民卫生出版社，2015.

中国医药教育协会感染疾病专业委员会. 抗菌药物药代动力学/药效学理论临床应用专家共识[J]. 中华结核和呼吸杂志，2018，41（6）：409-446.

吕鹏，王运红，樊晖晖，等. 替加环素致低纤维蛋白原血症的危险因素和可能机制[J]. 中国医院药学杂志，2021，41（15）：1587-1590.

NARANJO C A，BUSTO U，SELLERS E M，et al. A method for estimating the probability of adverse drug reactions[J] .Clin Pharmacol Ther，1981，30（2）：239-245.

HU J，XIAO Y H，ZHENG Y，et al. Clinical characteri-stics and risk factors of tigecycline-associated hypofibrinogenaemia in critically ill patients[J]. Eur J Clin Pharmacol，2020，76（7）：913-922.

GUO M X，LIANG J W，LI D D，et al. Coagulation dysfunction events associated with tigecycline：a real-world study from FDA adverse event reporting system（FAERS）database[J]. Thromb J，2022，20（1）：12.

ZHANG Q，WANG J E，LIU H，et al. Risk factors for tigecycline-induced hypofibrinogenaemia[J]. J Clin Pharm Ther，2020，45（6）：1434-1441.

CAMPANY-HERRERO D，LARROSA-GARCIA M，LALUEZA-BROTO P，et al. Tigecycline-associated hypofibrinogenemia in a real-world setting[J]. Int J Clin Pharm，2020，42（4）：1184-1189.

LIU J，YAN Y Y，ZHANG F. Risk factors for tigecycline-associated hypofibrinogenemia[J]. Ther Clin Risk Manag，2021，17：325-332.

LEI H B，LIU X，LI Z J，et al. Analysis of the clinical characteristics of tigecycline-induced hypofibrinogenemia[J]. J Chemother，2022，29：1-6.

中国医药教育协会感染疾病专业委员会，中华结核和呼吸杂志编辑委员会，中国药学会药物临床评价研究专业委员会. 抗菌药物超说明书用法专家共识[J]. 中华结核和呼吸杂志，2015，38（6）：410-444.

王明贵. 广泛耐药革兰阴性菌感染的实验诊断、抗菌治疗及医院感染控制：中国专家共识[J]. 中国感染与化疗杂志，2017，17（1）：82-92.

张静. 基于FAERS数据库的替加环素安全性评价及其对凝血指标影响的临床研究[D]. 重庆：陆军军医大学，2019.

AKALAY S，VANASSCHE T，DE MUNTER P. Tigecycline-induced life-threatening coagulopathy in a patient with a Mycobacterium abscess：a case report and step-by-step diagnostic approach[J]. Acta Clin Belg，2021，76（5）：410-414.

SABANIS N，PASCHOU E，GAVRIILAKI E，et al. Hypofibrinogenemia induced by tigecycline：a potentially life-threatening coagulation disorder[J]. Infect Dis，2015，47（10）：743-746.

ROUTSI C，KOKKORIS S，DOUKA E，et al. High-dose tigecycline-associated alterations in coagulation para-meters in critically ill patients with severe infections[J]. Int J Antimicrob Agents，2015，45（1）：90-93.

ROSSITTO G，PIANO S，ROSI S，et al. Life-threatening coagulopathy and hypofibrinogenaemia induced by tige-cycline in a patient with advanced liver cirrhosis[J]. Eur J Gastroenterol Hepatol，2014，26（6）：681-684.

PIERINGER H，SCHMEKAL B，BIESENBACH G，et al. Severe coagulation disorder with hypofibrinogenemia associated with the use of tigecycline[J]. Ann Hematol，2010，89（10）：1063-1064.

WU X Q，ZHAO P，DONG L，et al. A case report of patient with severe acute cholangitis with tigecycline treatment causing coagulopathy and hypofibrinogenemia[J]. Medicine，2017，96（49）：e9124.

VASSE M，PAYSANT I，SORIA J，et al. Down-regulation of fibrinogen biosynthesis by IL-4，IL-10 and IL-13[J]. Br J Haematol，1996，93（4）：955-961.

SALIBA R，PAASCH L，EL SOLH A. Tigecycline attenuates staphylococcal superantigen-induced T-cell proliferation and production of cytokines and chemokines[J]. Immunopharmacol Immunotoxicol，2009，31（4）：583-588.

李伟杰，卢圆圆. 肾移植围术期替加环素致低纤维蛋白原血症1例及文献复习[J]. 亚太传统医药，2020，16（3）：157-159.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

No data

Related Author

No data

Related Institution

No data

Address：8/F,129 Daping Main Street,Yuzhong District,Chongqing 400042,P.R.China
Technical support is provided by Beijing Founder Electronics co., LTD 渝ICP备15012710号公网安备50010302001817
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰