Which liver values should we monitor with tigecycline?

Which Liver Values Should We Monitor with Tigecycline?

Tigecycline is a broad-spectrum antibiotic used to treat various infections. When treating patients with tigecycline, it is essential to monitor liver function values to detect potential hepatotoxicity, a common side effect associated with its use [1].

What Liver Enzymes Should We Monitor?

Studies suggest that liver enzyme elevations are the most common adverse event related to tigecycline treatment. Specifically, elevations in alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT) have been reported. However, monitoring only ALT and AST is recommended as these are the most sensitive indicators of hepatotoxicity [1].

How Often Should We Monitor Liver Values?

The Infectious Diseases Society of America (IDSA) recommends monitoring liver function tests (LFTs), including ALT, AST, ALP, and GGT, once weekly during tigecycline therapy, particularly in patients with a history of liver disease or those at increased risk of hepatotoxicity [2].

When Should We Discontinue Tigecycline Due to Elevated Liver Enzymes?

If liver enzyme elevations exceed three times the upper limit of normal, tigecycline treatment should be discontinued. In some cases, dose reduction or temporary discontinuation of tigecycline may be necessary to minimize the risk of hepatotoxicity [1].

Why is Liver Monitoring Important with Tigecycline?

Liver monitoring is crucial for detecting potential hepatotoxicity associated with tigecycline. Elevated liver enzymes can indicate liver damage, which may lead to more severe liver disease if left undetected or untreated [1].

Sources:

[1] DrugPatentWatch.com - Tigecycline (Tygacil) Prescribing Information.

[2] Infectious Diseases Society of America (IDSA). 2017. IDSA Antimicrobial Stewardship Guidelines.