minocycline and Blood-Coagulation-Disorders

Tigecycline is the first member of the glycylcycline family. There are rarely reports of tigecycline causing coagulopathy and hypofibrinogenemia until now. We report a case on tigecycline-associated coagulopathy and hypofibrinogenemia and discuss the characteristics of the adverse reaction.. A 47-year-old male patient with severe acute cholangitis who developed sepsis was treated with a high dosage (100 mg twice daily) of tigecycline. He experienced coagulopathy and hypofibrinogenemia as substantiated by increased levels of prolonged prothrombin time (PT), the international normalized ratio (INR) and activated partial thromboplastin time (APTT), and in particular, the fibrinogen (FIB) levels obviously decreased.. Coagulopathy and hypofibrinogenemia.. We discontinued tigecycline and gave the patient several blood products to prevent spontaneous bleeding.. The adverse reaction disappeared after the withdrawal of tigecycline. After 30 days of hospitalization, the patient discharged with symptom free.. We suggest that coagulation parameters should be closely monitored in patients treated with tigecycline, specifically in patients who may be renal insufficiency, female or use the high-dose.

Topics: Afibrinogenemia; Anti-Bacterial Agents; Blood Coagulation Disorders; Cholangitis; Humans; Male; Middle Aged; Minocycline; Sepsis; Tigecycline

A case of coagulopathy in association with tigecycline use is described.. A 63-year-old morbidly obese, wheelchair-bound man was hospitalized for assessment of a possibly infected decubitus ulcer and surgical evaluation for placement of a diverting colostomy; he had been transferred from another facility after initiation of triple-agent antimicrobial therapy for suspected fecal infection of the ulcer. Based on the results of an ulcer swab culture, the patient's antibiotic regimen was modified (initially to i.v. ertapenem and then to tigecycline on hospital day 10). An International Normalized Ratio (INR) value obtained incidentally within days of tigecycline initiation was slightly elevated (1.2), but no workup was performed at that time. It was determined that the patient would benefit from a colostomy procedure, which was performed about three weeks later (he spent most of the intervening time at a rehabilitation facility, where i.v. tigecycline therapy was continued). During a routine preoperative workup, the patient's INR was found to be elevated (2.1). No identifiable causes for the INR elevation were noted, and the coagulopathy was treated successfully with fresh frozen plasma; the colostomy procedure was uncomplicated. Postoperatively, it was theorized that the development of coagulopathy in this case might have been secondary to tigecycline use. After discontinuation of tigecycline therapy and a switch to an alternative antimicrobial regimen, the patient's INR values normalized within a few days.. A patient with a possibly infected decubitus ulcer was treated with tigecycline and subsequently developed a coagulopathy.

Topics: Anti-Bacterial Agents; Blood Coagulation Disorders; Colostomy; Humans; International Normalized Ratio; Male; Middle Aged; Minocycline; Plasma; Pressure Ulcer; Tigecycline

Topics: Adult; Aged; Anti-Bacterial Agents; Bacterial Infections; Blood Coagulation Disorders; Critical Illness; Female; Fibrinogen; Humans; Male; Middle Aged; Minocycline; Partial Thromboplastin Time; Tigecycline

A 74-year-old female patient with end-stage renal disease, undergoing periodic hemodialysis, was hospitalized due to infection by multidrug-resistant Acinetobacter baumannii after hip replacement surgery. She was treated with tigecycline, a glycylcycline agent. Subsequently she developed coagulation disorders as substantiated by increased international normalized ratio (INR), prolonged partial thromboplastin time (aPTT), and severe hypofibrinogenemia, followed by transaminasemia, cholestasis, and anemia. Ultrasonography and computed tomography revealed no underlying pathological entities. Tigecycline was discontinued and the patient underwent daily hemodialysis and received multiple fresh frozen plasma transfusions. Additionally, she was treated with colistin. Her clinical and laboratory status improved. We suggest that patients treated with tigecycline should be monitored for changes in INR, aPTT, and fibrinogen levels to avoid severe, life-threatening coagulation disturbances.

Topics: Acinetobacter baumannii; Acinetobacter Infections; Aged; Anti-Bacterial Agents; Blood Coagulation Disorders; Colistin; Drug Resistance, Multiple, Bacterial; Female; Humans; International Normalized Ratio; Kidney Failure, Chronic; Minocycline; Partial Thromboplastin Time; Renal Dialysis; Tigecycline

Bacterial infections because of multidrug-resistant (MDR) bacteria are spreading worldwide. In patients with advanced liver cirrhosis, healthcare-acquired and hospital-acquired infections are common and are frequently sustained by MDR bacteria. In these settings, tigecycline, a new antibiotic, has been shown to be useful in the treatment of MDR bacteria, and it has been proposed for the treatment of hospital-acquired infections in patients with cirrhosis. Nevertheless, poor data exist on the safety profile of tigecycline in patients with cirrhosis. Here, an experience is reported in a female patient with advanced liver cirrhosis, who developed sepsis by an MDR Stenotrophomonas maltophilia and was treated with tigecycline. She experienced life-threatening side effects consisting of severe coagulopathy with hypofibrinogenaemia and subsequent gastrointestinal haemorrhage. The side effect disappeared after the withdrawal of tigecycline. Therefore, a strict monitoring of coagulation parameters in patients with cirrhosis treated with tigecycline is recommended.

Topics: Adult; Afibrinogenemia; Anti-Bacterial Agents; Blood Coagulation Disorders; Cross Infection; Drug Resistance, Multiple, Bacterial; Female; Gram-Negative Bacterial Infections; Humans; Liver Cirrhosis; Minocycline; Opportunistic Infections; Stenotrophomonas maltophilia; Tigecycline

Topics: Afibrinogenemia; Anti-Bacterial Agents; Blood Coagulation Disorders; Female; Humans; Middle Aged; Minocycline; Peritonitis; Tigecycline