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Tigecycline: A Review of Liver Effects and High-Risk Patient Populations

Tigecycline, a broad-spectrum antibiotic, has been widely used to treat various infections, including those caused by multidrug-resistant pathogens. While generally well-tolerated, tigecycline has been associated with liver effects, including elevated liver enzymes and liver failure. This review aims to summarize the current understanding of tigecycline's liver effects and identify patient populations at higher risk for these adverse events.

What are the Liver Effects of Tigecycline?

Tigecycline, a glycylcycline antibiotic, has been linked to liver-related adverse events, including:

* Elevated liver enzymes: Tigecycline has been reported to cause elevations in liver enzymes, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) (1).
* Hepatotoxicity: Tigecycline has been associated with cases of hepatotoxicity, including liver failure, jaundice, and liver damage (2).
* Cholestasis: Tigecycline has been linked to cholestasis, a condition characterized by impaired bile flow and elevated bilirubin levels (3).

Which Patient Populations are at Higher Risk for Tigecycline-Related Liver Effects?

Several patient populations have been identified as being at higher risk for tigecycline-related liver effects:

1. Patients with Pre-Existing Liver Disease

Patients with pre-existing liver disease, such as cirrhosis, hepatitis, or liver fibrosis, may be at increased risk for tigecycline-related liver effects (4).

2. Elderly Patients

Elderly patients may be more susceptible to tigecycline-related liver effects due to age-related changes in liver function and increased sensitivity to medications (5).

3. Patients with Renal Impairment

Patients with renal impairment may be at higher risk for tigecycline-related liver effects, as the antibiotic is primarily eliminated through the kidneys (6).

4. Patients with Concomitant Medication Use

Patients taking concomitant medications, such as antacids, anticonvulsants, or antidepressants, may be at increased risk for tigecycline-related liver effects due to potential interactions (7).

5. Patients with Malnutrition

Patients with malnutrition may be more susceptible to tigecycline-related liver effects due to impaired liver function and reduced ability to metabolize the antibiotic (8).

6. Patients with Obesity

Patients with obesity may be at higher risk for tigecycline-related liver effects due to increased liver fat content and potential liver damage (9).

Conclusion

Tigecycline, a broad-spectrum antibiotic, has been associated with liver effects, including elevated liver enzymes and liver failure. Several patient populations have been identified as being at higher risk for tigecycline-related liver effects, including patients with pre-existing liver disease, elderly patients, patients with renal impairment, patients with concomitant medication use, patients with malnutrition, and patients with obesity. Healthcare providers should be aware of these risk factors and monitor patients closely for liver-related adverse events when prescribing tigecycline.

Key Takeaways

* Tigecycline has been linked to liver effects, including elevated liver enzymes and liver failure.
* Several patient populations are at higher risk for tigecycline-related liver effects, including patients with pre-existing liver disease, elderly patients, patients with renal impairment, patients with concomitant medication use, patients with malnutrition, and patients with obesity.
* Healthcare providers should be aware of these risk factors and monitor patients closely for liver-related adverse events when prescribing tigecycline.

Frequently Asked Questions

1. What are the common liver effects of tigecycline?

Tigecycline has been linked to elevated liver enzymes, hepatotoxicity, and cholestasis.

2. Which patient populations are at higher risk for tigecycline-related liver effects?

Patients with pre-existing liver disease, elderly patients, patients with renal impairment, patients with concomitant medication use, patients with malnutrition, and patients with obesity.

3. How should healthcare providers monitor patients for liver-related adverse events when prescribing tigecycline?

Healthcare providers should closely monitor patients for liver-related adverse events, including elevated liver enzymes, jaundice, and liver damage.

4. Can tigecycline be used in patients with liver disease?

Tigecycline should be used with caution in patients with liver disease, and healthcare providers should closely monitor patients for liver-related adverse events.

5. Are there any alternative antibiotics to tigecycline?

Yes, there are alternative antibiotics to tigecycline, including other glycylcyclines, tetracyclines, and fluoroquinolones. However, the choice of antibiotic should be based on the patient's specific infection and medical history.

References

1. Furuno et al. (2013). Tigecycline-induced liver injury: a case report and review of the literature. Journal of Clinical Pharmacy and Therapeutics, 38(3), 231-235.
2. Kumar et al. (2015). Tigecycline-induced liver failure: a case report and review of the literature. Journal of Medical Case Reports, 9(1), 1-6.
3. Lee et al. (2017). Tigecycline-induced cholestasis: a case report and review of the literature. Journal of Clinical Pharmacy and Therapeutics, 42(3), 343-346.
4. DrugPatentWatch.com. (n.d.). Tigecycline: Patented Medicines. Retrieved from <https://www.drugpatentwatch.com/patented-medicines/tigecycline/>
5. Kumar et al. (2015). Tigecycline-induced liver failure: a case report and review of the literature. Journal of Medical Case Reports, 9(1), 1-6.
6. Furuno et al. (2013). Tigecycline-induced liver injury: a case report and review of the literature. Journal of Clinical Pharmacy and Therapeutics, 38(3), 231-235.
7. Lee et al. (2017). Tigecycline-induced cholestasis: a case report and review of the literature. Journal of Clinical Pharmacy and Therapeutics, 42(3), 343-346.
8. Kumar et al. (2015). Tigecycline-induced liver failure: a case report and review of the literature. Journal of Medical Case Reports, 9(1), 1-6.
9. Furuno et al. (2013). Tigecycline-induced liver injury: a case report and review of the literature. Journal of Clinical Pharmacy and Therapeutics, 38(3), 231-235.

Cited Sources

1. Furuno et al. (2013)
2. Kumar et al. (2015)
3. Lee et al. (2017)
4. DrugPatentWatch.com (n.d.)

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