Retrospective analysis of tigecycline-associated hypofibrinogenemia in patients with hypoproteinemia

doi:10.5246/jcps.2025.06.044

Abstract

Abstract:

This study aimed to investigate the prevalence and risk factors associated with tigecycline-induced hypofibrinogenemia, providing critical insights for safer clinical drug use. A retrospective analysis was conducted on the medical records of patients with hypoproteinemia who received tigecycline treatment during hospitalization between January 1, 2020, and December 31, 2023. Key patient information was collected, including age, gender, weight, history of hematological diseases, medication dosage, treatment duration, concomitant medications, serum albumin and fibrinogen (FIB) levels before and after tigecycline administration, hepatic and renal function parameters, and other clinical characteristics. Patients were categorized into adverse drug reaction (ADR) and non-ADR groups, and comparisons were made to identify baseline characteristics and drug-related factors influencing tigecycline-induced FIB level reductions. Among 222 eligible patients, 71 (31.98%) developed hypofibrinogenemia. Univariate analysis identified significant associations between hypofibrinogenemia and treatment duration (P = 0.000), baseline FIB levels (P = 0.006), concomitant use of cefoperazone-sulbactam (P = 0.034), and concurrent administration of fat emulsion and heparin sodium injections (P < 0.044). Further multivariate logistic regression analysis revealed that a baseline FIB level below 5.1 g/L and concomitant use with cefoperazone-sulbactam were independent risk factors for tigecycline-induced FIB reduction. Conversely, a treatment duration of fewer than 9 d and higher albumin levels (light/medium/weight) were protective factors that reduced the risk of hypofibrinogenemia. This study highlighted that tigecycline-induced hypofibrinogenemia was a frequently encountered adverse effect in clinical practice. Patients with hypoproteinemia should undergo thorough evaluation prior to tigecycline administration, with particular attention to baseline FIB and albumin levels. Long-term use should be avoided, and combinations with medications that impair coagulation function should be minimized to mitigate the risk of hypofibrinogenemia associated with tigecycline.

Key words: Tigecycline, Hypoproteinemia, Hypofibrinogenemia, Real-world study

Supporting:

Xiuzhen Liu, Jianjun Liu, Weiju Xue, Haiyan Xing, Yingli Zhao, Xing Fang. Retrospective analysis of tigecycline-associated hypofibrinogenemia in patients with hypoproteinemia[J]. Journal of Chinese Pharmaceutical Sciences, 2025, 34(6): 581-591.

Figures/Tables 5

Table 1. Basic information of 222 included patients.

Table 2. Clinical data statistics and univariate analysis of included patients.

Table 3. Statistical table of multivariate logistic regression analysis.

Table 4. Statistical table of patient information in the ADR group.

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