tetracycline and Pancreatitis

Eravacycline is the newest member of the broad-spectrum class of tetracycline antimicrobials. Pancreatitis has been previously associated with the tetracycline class of antibiotics, but, to our knowledge, we believe that this is the first reported case of eravacycline-induced pancreatitis. We describe a 46-year-old male who received eravacycline for treatment of a perirectal abscess. While the patient had slightly elevated lipase levels at baseline post-cardiopulmonary arrest, he developed abdominal pain and a further increase in lipase levels following 10 days of eravacycline, consistent with pancreatitis. Based on the Naranjo adverse drug reaction probability scale, eravacycline was the probable etiology of acute pancreatitis given improvement immediately after discontinuation. Clinicians should be aware of this potential adverse effect of eravacycline and should not initiate eravacycline in those with risk factors for acute pancreatic injury. However, acute pancreatitis should be suspected in all patients complaining of symptoms followed by immediate discontinuation of eravacycline.

Topics: Acute Disease; Anti-Bacterial Agents; Humans; Lipase; Male; Middle Aged; Pancreatitis; Tetracycline; Tetracyclines

The diagnosis of drug-induced acute pancreatitis often is difficult to establish. Although some medications have been shown to cause acute pancreatitis with a large body of evidence, including rechallenge, some medications have been attributed as a cause of acute pancreatitis merely by a single published case report in which the investigators found no other cause. In addition, some medications reported to have caused acute pancreatitis have obvious patterns of presentation, including the time from initiation to the development of disease (latency). There also appear to be patterns in the severity of disease. After reviewing the literature, we have classified drugs that have been reported to cause acute pancreatitis based on the published weight of evidence for each agent and the pattern of clinical presentation. Based on our analysis of the level of evidence, 4 classes of drugs could be identified. Class I drugs include medications in which at least 1 case report described a recurrence of acute pancreatitis with a rechallenge with the drug. Class II drugs include drugs in which there is a consistent latency in 75% or more of the reported cases. Class III drugs include drugs that had 2 or more case reports published, but neither a rechallenge nor a consistent latency period. Class IV drugs were similar to class III drugs, but only 1 case report had been published. Our analysis allows an evidence-based approach when suspecting a drug as causing acute pancreatitis.

Topics: Acute Disease; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Pancreatitis; Tetracycline

Tetracycline has long been implicated as a causative agent in acute pancreatitis. Early reports of acute pancreatitis after tetracycline administration were associated with liver dysfunction attributed to the drug's ability to induce fatty degeneration of this organ. At present, few data are available to suggest that tetracycline-induced pancreatitis may occur in the absence of overt liver failure. We report here, the third and fourth cases of acute pancreatitis after the administration of oral tetracycline in patients without evidence of liver abnormalities. A review of the relevant literature is presented.

Topics: Acute Disease; Administration, Oral; Adolescent; Humans; Male; Pancreatitis; Tetracycline

To the best of our knowledge, no case of acute pancreatitis associated with brucellosis has been reported. This report details the occurrence of acute pancreatitis in which Brucella melitensis was cultured from blood. We discuss various diagnostic tests and the recommended therapy for brucellosis.

Topics: Acute Disease; Adult; Brucellosis; Drug Therapy, Combination; Humans; Male; Pancreatitis; Streptomycin; Tetracycline

We critically reviewed the English language literature pertaining to drug-induced pancreatitis and attempted to determine whether the reported association between each drug and pancreatitis was valid. The following drugs seem to cause pancreatitis: azathioprine, thiazides, sulfonamides, furosemide, estrogens, and tetracycline. Less convincing, but suggestive evidence exists for: 1-asparaginase, iatrogenic hypercalcemia, chlorthalidine, corticosteroids, ethacrynic acid, phenformin, and procainamide. Evidence implicating other drugs is either inadequate or contradictory. Little is known about the pathogenesis of drug-induced pancreatitis. Ethanol was not considered in this review.

Topics: Acetaminophen; Adrenal Cortex Hormones; Amphetamines; Asparaginase; Azathioprine; Chlorthalidone; Cholestyramine Resin; Cimetidine; Cyproheptadine; Dextropropoxyphene; Diazoxide; Diuretics; Estrogens; Ethacrynic Acid; Furosemide; Histamine; Humans; Hypercalcemia; Indomethacin; Isoniazid; Mercaptopurine; Narcotics; Pancreatitis; Phenformin; Procainamide; Rifampin; Salicylates; Sodium Chloride Symporter Inhibitors; Sulfonamides; Tetracycline

In acute pancreatitis the standard treatment is with antibiotics given prophylactically. Available studies indicate that the usefulness of such chemotherapy in the milder form of the disease (degree of severity I) has not yet been fully established. In the absence of contradictory results, prophylactic antibiotic treatment can, however, be recommended in severe pancreatitis (degrees II and III) and in those conditions induced by ethyl or of idiopathic origin. In all forms showing underlying biliary tract disease and in pancreatitis complicated by infection, antibiotic treatment should invariably be administered. Administration of broad-spectrum antibiotics which can be excreted via the bile duct, e.g. ampicillin or tetracycline, is preferable.

Topics: Acute Disease; Ampicillin; Anti-Bacterial Agents; Clinical Trials as Topic; Humans; Pancreatitis; Prospective Studies; Random Allocation; Tetracycline

Topics: Adolescent; Adult; Aged; Cholangiography; Cholangitis; Colitis, Ulcerative; Diagnosis, Differential; Drainage; Female; Hepatitis B Antigens; Humans; Liver; Male; Middle Aged; Pancreatitis; Phlebitis; Portal Vein; Sclerosis; Shwartzman Phenomenon; Tetracycline

Topics: Administration, Oral; Chemical and Drug Induced Liver Injury; Child; Fatty Liver; Female; Glomerular Filtration Rate; Humans; Liver; Male; Pancreatitis; Pregnancy; Pregnancy Complications; Protein Biosynthesis; Tetracycline; Uremia

In acute pancreatitis the standard treatment is with antibiotics given prophylactically. Available studies indicate that the usefulness of such chemotherapy in the milder form of the disease (degree of severity I) has not yet been fully established. In the absence of contradictory results, prophylactic antibiotic treatment can, however, be recommended in severe pancreatitis (degrees II and III) and in those conditions induced by ethyl or of idiopathic origin. In all forms showing underlying biliary tract disease and in pancreatitis complicated by infection, antibiotic treatment should invariably be administered. Administration of broad-spectrum antibiotics which can be excreted via the bile duct, e.g. ampicillin or tetracycline, is preferable.

Topics: Acute Disease; Ampicillin; Anti-Bacterial Agents; Clinical Trials as Topic; Humans; Pancreatitis; Prospective Studies; Random Allocation; Tetracycline

To evaluate the suggested association between tetracycline and acute pancreatitis in a large pharmacoepidemiological study.. The use of tetracycline in relation to the risk of acute pancreatitis was examined in a nationwide case-control study of people aged 40-84 years between 2006 and 2008 in Sweden. The Swedish Patient Register was used to identify 6161 cases of first-episode acute pancreatitis. The Register of the Total Population was used to randomly select 61,637 control subjects from the general population using frequency-based density sampling, matched for age, sex, and calendar year. Tetracycline use was defined as 'current', 'recent', 'past' or 'former' if the drug had been dispensed 0-30 days, 31-180 days, 181-365 days or 1-3½ years before the index date, respectively. The risk of acute pancreatitis was estimated by unconditional logistic regression, providing ORs with 95% CIs, adjusted for potential confounding factors.. There was a 60% increased risk of acute pancreatitis among current users of tetracycline after adjustment for potential confounders (OR=1.6, 95% CI 1.2 to 2.1). There was no increased OR for any category of previous use.. Current use of tetracycline is associated with an increased risk of acute pancreatitis, verifying previous case reports.

Topics: Acute Disease; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Case-Control Studies; Confidence Intervals; Female; Humans; Logistic Models; Male; Middle Aged; Odds Ratio; Pancreatitis; Risk Factors; Sweden; Tetracycline

Topics: Acute Disease; Azathioprine; Furosemide; Humans; Pancreatitis; Sulfonamides; Tetracycline

A 21-year-old man developed acute pancreatitis on two separate occasions after a short-term course (less than 10 days) of tetracycline in the presence of normal liver and renal function. Although tetracycline is frequently listed as a cause of pancreatitis, this is only the second documented case of tetracycline-induced pancreatitis in an otherwise healthy person. We review the pertinent literature.

Topics: Acute Disease; Adult; Humans; Male; Pancreatitis; Tetracycline; Urethritis

Topics: Asparaginase; Azathioprine; Diuretics; Drug-Related Side Effects and Adverse Reactions; Estrogens; Humans; Pancreatitis; Sulfonamides; Tetracycline; Valproic Acid

93 publications concerning drug-induced pancreatitis are reviewed. A confirmed causal relationship between drug and acute pancreatitis so far exists only for 8 compounds: azathioprine, chlorothiazide, furosemide, sulfonamides, tetracycline, estrogens, valproic acid and L-asparaginase. There is less convincing, but still suggestive, evidence for a causal relationship with 5 other drugs, namely: corticosteroids, chlorthalidone, ethacrynic acid, phenformin and iatrogenic hypercalcemia. Due to inadequate or contradictory evidence, the link between a number of additional drugs and acute pancreatitis is considered possible, conditional or doubtful. Finally, the scant literature concerning the pathogenesis and histological lesions of drug-induced pancreatitis is briefly reviewed.

Topics: Acute Disease; Asparaginase; Azathioprine; Chlorothiazide; Drug-Related Side Effects and Adverse Reactions; Estrogens; Furosemide; Humans; Pancreatitis; Sulfonamides; Tetracycline; Valproic Acid

The assumption that tetracycline HCl can cause acute pancreatitis has been accepted since reports began to appear implicating it as a cause of fatty liver in pregnancy with associated pancreatitis. It is listed as an etiologic factor for acute pancreatitis in reference articles and standard medical textbooks without good documentation of this association in the absence of fatty liver. This report describes a documented case of tetracycline HCl-induced acute pancreatitis without associated overt liver disease.

Topics: Acne Vulgaris; Acute Disease; Adolescent; Female; Humans; Pancreatitis; Tetracycline

Topics: Amylases; Aprotinin; Atropine; Clinical Enzyme Tests; Diuretics; Humans; Lipase; Pancreatic Diseases; Pancreatitis; Radionuclide Imaging; Tetracycline

Topics: Acute Disease; Adult; Amylases; Electrocardiography; Ethanol; Female; Heart Diseases; Humans; Hypertension; Infusions, Parenteral; Male; Meperidine; Middle Aged; Pancreatitis; Prospective Studies; Tetracycline; Vision Disorders

Topics: Aluminum Hydroxide; Chronic Disease; Gastritis; Gastroesophageal Reflux; Gastrointestinal Diseases; Humans; Hydrochloric Acid; Lipase; Pancreatitis; Pepsin A; Peptic Ulcer; Silver Nitrate; Stomatitis, Aphthous; Tetracycline

Topics: Acute Disease; Ampicillin; Amylases; Anti-Bacterial Agents; Chloramphenicol; Humans; Lipase; Pancreatitis; Sulfonamides; Tetracycline

Topics: Cholecystitis; Humans; Pancreatitis; Pneumonia; Tetracycline

Topics: Abdomen; Adolescent; Adult; Aged; Anti-Bacterial Agents; Bronchiectasis; Child; Cholecystitis; Female; Humans; Injections, Intravenous; Lung Abscess; Lung Diseases; Male; Middle Aged; Morpholines; Myocarditis; Oleandomycin; Osteomyelitis; Pancreatitis; Peritonitis; Pneumonia; Tetracycline; Thoracic Surgery; Thorax

Topics: Acute Disease; Adult; Aged; Bile; Biliary Tract Diseases; Exudates and Transudates; Female; Humans; Male; Middle Aged; Pancreatitis; Tetracycline

Topics: Acute Disease; Adult; Amylases; Child; Digestive System; Electrophoresis; Female; Hepatitis A; Humans; Male; Pancreatitis; Prednisone; Radiography; Tetracycline

Topics: Acute Disease; Animals; Anti-Bacterial Agents; Colistin; Dogs; Erythromycin; Female; Kanamycin; Kidney; Lincomycin; Liver; Pancreas; Pancreatic Juice; Pancreatitis; Staphylococcus; Tetracycline; Toxins, Biological

Topics: Adult; Animals; Bone and Bones; Bone Neoplasms; Chondrosarcoma; Fluorescence; Humans; Infection Control; L Forms; Male; Mice; Pancreatitis; Pericarditis; Pneumonia; Postoperative Complications; Rabbits; Tetracycline

Topics: Adult; Aged; Esophagitis; Female; Humans; Injections, Intramuscular; Injections, Intravenous; Intestines; Male; Middle Aged; Oleandomycin; Pancreatitis; Tetracycline

Topics: Adult; Aged; Fatty Liver; Female; Humans; Jaundice; Middle Aged; Neoplasms; Pancreatitis; Postoperative Complications; Pregnancy; Pregnancy Complications; Tetracycline

Topics: Anti-Bacterial Agents; Brain Diseases; Drug Therapy; Fatty Liver; Female; Kidney Diseases; Pancreatitis; Pregnancy; Pregnancy Complications; Pyelonephritis; Tetracycline; Toxicology

Topics: Acute Kidney Injury; Adult; Cesarean Section; Cholecystitis; Female; Humans; Pancreatitis; Pregnancy; Pregnancy Complications; Tetracycline

Topics: Anti-Bacterial Agents; Clostridium; Dogs; Duodenum; Escherichia coli; Hemorrhage; Intestines; Neomycin; Pancreatic Ducts; Pancreatitis; Penicillins; Research; Sulfamethoxazole; Sulfonamides; Surgical Procedures, Operative; Tetracycline

Topics: Animals; Anti-Bacterial Agents; Dogs; Gastrointestinal Hemorrhage; Hemorrhage; Hypothermia; Hypothermia, Induced; Mortality; Neomycin; Pancreatic Juice; Pancreatitis; Propylthiouracil; Research; Tetracycline

Topics: Chloramphenicol; Clinical Enzyme Tests; Escherichia coli Infections; Female; Humans; Jaundice; Jaundice, Obstructive; Liver Diseases; Liver Function Tests; Pancreas; Pancreatitis; Pregnancy; Pregnancy Complications; Pyelonephritis; Streptomycin; Tetracycline; Toxicology; Uremia

Topics: Adolescent; Amylases; Anti-Bacterial Agents; Barium Sulfate; Child; Cholecystography; Clinical Enzyme Tests; Humans; Meperidine; Methantheline; Pancreatitis; Quaternary Ammonium Compounds; Radiography; Tetracycline

Topics: Anti-Bacterial Agents; Biomedical Research; Chlortetracycline; Enzyme Inhibitors; Humans; Lipase; Pancreatitis; Tetracycline

Topics: Anti-Bacterial Agents; Calcification, Physiologic; Calculi; Kidney Diseases; Muscles; Myocardium; Neoplasms; Pancreatitis; Tetracycline

Topics: Humans; Inflammation; Myocardial Infarction; Pancreatitis; Shock; Tetracycline

Topics: Anti-Bacterial Agents; Oleandomycin; Pancreatitis; Protein Synthesis Inhibitors; Tetracycline

Topics: Anti-Bacterial Agents; Humans; Pancreatitis; Protein Synthesis Inhibitors; Tetracycline