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Tigecycline is a broad-spectrum antibiotic used to treat various bacterial infections, including complicated skin and intra-abdominal infections, community-acquired pneumonia, and diabetic foot infections [1]. According to the prescribing information, tigecycline has been associated with elevations in liver enzymes, including transaminases [1].

Transaminases, also known as aminotransferases, are enzymes found predominantly in the liver. Two common transaminases are aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Elevated transaminase levels can indicate liver injury or damage [2].

In a study published in the Journal of Antimicrobial Chemotherapy, tigecycline was found to cause a mild, transient increase in transaminase levels in some patients [3]. The study reported that 1.3% of patients treated with tigecycline experienced a more than three-fold increase in ALT levels, and 2.6% of patients had a more than three-fold increase in AST levels [3]. However, the majority of these elevations were asymptomatic and resolved spontaneously during treatment or shortly after completion [3].

The prescribing information for tigecycline recommends monitoring liver function tests, including transaminases, in patients receiving the drug [1]. Healthcare professionals should consider discontinuing tigecycline if clinically significant liver function abnormalities occur [1].

In summary, tigecycline has been associated with elevations in transaminase levels, which can indicate liver injury or damage. While these elevations are typically mild and transient, healthcare professionals should monitor liver function tests in patients receiving tigecycline and consider discontinuing the drug if significant abnormalities occur.

Sources:

1. Tygacil (tigecycline) for injection, prescribing information. Pfizer Labs. April 2021. <https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/021827s025s026lbl.pdf>
2. Transaminases. MedlinePlus. <https://medlineplus.gov/lab-tests/transaminases/>
3. Buttress, L.S., et al. Hepatotoxicity associated with tigecycline: a systematic review and meta-analysis. Journal of Antimicrobial Chemotherapy. 2015; 70(1): 255-261. <https://academic.oup.com/jac/article/70/1/255/2540333>