Analysis of clinical characteristics of tigecycline-induced acute pancreatitis.

Abstract

The purpose of this study is to explore the clinical characteristics of tigecycline-induced acute pancreatitis. We searched the PubMed/Medline, Web of Knowledge, OVID, Elsevier, Springer Link, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Chinese VIP databases from 2005 and identified 19 studies of tigecycline-induced acute pancreatitis involving a total of 22 patients for inclusion in a retrospective analysis. The median (range)age of 22 patients with acute pancreatitis was 58years (range 9-83). Overall, the median (range) time of symptom onset was 6.5days (range 2-28), or 6days (range 2-14) and 6days (range 3-28) in patients with or without a loading dose of tigecycline, respectively. Symptoms included nausea, vomiting and abdominal distension (73%) and abdominal pain (73%); 90% (18/20) of patients developed mild acute pancreatitis (MAP), and 10% (2/20) developed severe acute pancreatitis (SAP). Computed tomography (CT) scans showed oedematous infiltrate in 56% (10/18) of cases and acute pancreatitis in 28% (5/18) of cases. The median (range) level of lipase and amylase was 936U/L (range 382-4089) and 588U/L (range 312-1166), respectively. The median (range) time to recovery of symptoms was 4days (range 1-10), and the time for recovery of pancreatic enzymes to the normal range was 5days (range 1-30) after the withdrawal of tigecycline in all patients. Clinicians should be particularly mindful of clinical signs and symptoms, the level of serum pancreatic enzymes and abdominal CT images in order to monitor the development of pancreatitis when using tigecycline.