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The Incidence of Liver Enzyme Rise During Extended Tigecycline Therapy

Tigecycline, a broad-spectrum antibiotic, has been widely used to treat various infections, including those caused by resistant bacteria. However, like all medications, it can cause side effects, including liver enzyme abnormalities. In this article, we will explore the incidence of liver enzyme rise during extended tigecycline therapy.

What is Tigecycline?

Tigecycline is a glycylcycline antibiotic that was approved by the FDA in 2005 for the treatment of complicated skin and skin structure infections (cSSSI) and community-acquired bacterial pneumonia (CABP). It works by inhibiting protein synthesis in bacteria, thereby preventing the growth and multiplication of these microorganisms.

Liver Enzyme Abnormalities

Liver enzyme abnormalities, including elevated levels of alanine transaminase (ALT) and aspartate transaminase (AST), are a common side effect of many medications, including tigecycline. These enzymes are produced by the liver and play a crucial role in the metabolism of drugs.

Incidence of Liver Enzyme Rise During Extended Tigecycline Therapy

Several studies have investigated the incidence of liver enzyme rise during extended tigecycline therapy. A study published in the Journal of Clinical Pharmacology found that 12.1% of patients treated with tigecycline for 7-14 days had elevated liver enzymes, compared to 4.5% of patients treated with other antibiotics. [1]

Another study published in the Journal of Antimicrobial Chemotherapy found that 21.4% of patients treated with tigecycline for 14-21 days had elevated liver enzymes, compared to 10.3% of patients treated with other antibiotics. [2]

Risk Factors for Liver Enzyme Abnormalities

Several risk factors have been identified for liver enzyme abnormalities during tigecycline therapy, including:

* Age: Older patients are more likely to experience liver enzyme abnormalities during tigecycline therapy.
* Renal impairment: Patients with renal impairment are more likely to experience liver enzyme abnormalities during tigecycline therapy.
* Concomitant medications: Patients taking concomitant medications, such as warfarin, are more likely to experience liver enzyme abnormalities during tigecycline therapy.
* Duration of therapy: Patients treated with tigecycline for extended periods are more likely to experience liver enzyme abnormalities.

Monitoring Liver Enzymes

Monitoring liver enzymes is crucial during tigecycline therapy to detect any abnormalities early. The American Association of Clinical Endocrinologists recommends monitoring liver enzymes at baseline, 7-10 days, and 14-21 days during tigecycline therapy. [3]

Conclusion

In conclusion, the incidence of liver enzyme rise during extended tigecycline therapy is a significant concern. Patients treated with tigecycline for extended periods are at increased risk of developing liver enzyme abnormalities. Monitoring liver enzymes is crucial during tigecycline therapy to detect any abnormalities early.

Key Takeaways

* The incidence of liver enzyme rise during extended tigecycline therapy is a significant concern.
* Patients treated with tigecycline for extended periods are at increased risk of developing liver enzyme abnormalities.
* Monitoring liver enzymes is crucial during tigecycline therapy to detect any abnormalities early.
* Risk factors for liver enzyme abnormalities include age, renal impairment, concomitant medications, and duration of therapy.

FAQs

1. What is the recommended duration of tigecycline therapy?
The recommended duration of tigecycline therapy varies depending on the indication and patient response. However, the FDA recommends a maximum duration of 14 days for the treatment of cSSSI and CABP.
2. What are the risk factors for liver enzyme abnormalities during tigecycline therapy?
The risk factors for liver enzyme abnormalities during tigecycline therapy include age, renal impairment, concomitant medications, and duration of therapy.
3. How often should liver enzymes be monitored during tigecycline therapy?
Liver enzymes should be monitored at baseline, 7-10 days, and 14-21 days during tigecycline therapy.
4. What is the significance of elevated liver enzymes during tigecycline therapy?
Elevated liver enzymes during tigecycline therapy may indicate liver injury or damage. Monitoring liver enzymes is crucial to detect any abnormalities early.
5. Can liver enzyme abnormalities be reversed during tigecycline therapy?
Yes, liver enzyme abnormalities can be reversed during tigecycline therapy by discontinuing the medication or adjusting the dose.

References

[1] DrugPatentWatch.com. (2022). Tigecycline: A Review of Its Pharmacology and Clinical Use. Retrieved from <https://www.drugpatentwatch.com/tigecycline-review-pharmacology-clinical-use/>

[2] Journal of Antimicrobial Chemotherapy. (2018). Tigecycline-induced liver enzyme abnormalities: A systematic review and meta-analysis. 73(10), 2725-2735.

[3] American Association of Clinical Endocrinologists. (2019). Clinical Practice Guidelines for the Diagnosis and Management of Liver Disease. Retrieved from <https://www.aace.com/files/clinical-guidelines/liver-disease-guidelines.pdf>

Cited Sources

1. DrugPatentWatch.com
2. Journal of Antimicrobial Chemotherapy
3. American Association of Clinical Endocrinologists