Standard dose could be better! A multicenter study of tigecycline in patients with liver failure.

IF 3.8 2区医学 Q1 INFECTIOUS DISEASES Expert Review of Anti-infective Therapy Pub Date : 2025-06-01 Epub Date: 2025-02-26 DOI:10.1080/14787210.2025.2472346

Jinlin Guo, Xinfeng Cai, Shan Wang, Hongping Wen, Jing Ren, Mi Zhou, Xingang Li, Xiaodan Yan, Shuangshuang Tian, Fang Zhang, Yanqin Liu, Wenjun Zhang, Yunyun Shao, Jianghong Cao, Xiaochun Liu, Kaixuan Hou, Dan Wei, Guan Lin

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Abstract

Background: High-dose (HD) tigecycline is often required for severe multidrug-resistant gram-negative infections in liver failure patients, despite package recommendations to halve the dose for those with severe liver impairment. This study evaluated the efficacy and safety of different tigecycline doses in this population.

Research design and methods: A retrospective cohort of 192 patients with Child-Pugh grade C liver failure was divided into label-dose (LD), standard-dose (SD), and HD groups. Primary and secondary outcomes included microbial eradication, mortality, and adverse effects.

Results: The SD group achieved higher microbial eradication than LD, with comparable efficacy to HD but fewer adverse events, such as fibrinogen requirements. High-dose treatment increased mortality risk (Hazard Ratio: 1.85, p = 0.062). Optimal microbial eradication and minimized adverse effects occurred with the SD group at 7 days of treatment.

Conclusions: Standard-dose tigecycline offers a balanced approach to microbial eradication and safety, making it preferable in liver failure patients.

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标准剂量可能更好！替加环素在肝功能衰竭患者中的多中心研究。

背景：高剂量（HD）替加环素通常用于治疗肝功能衰竭患者的严重多重耐药革兰氏阴性感染，尽管包装建议将严重肝损害患者的剂量减半。本研究评估了不同剂量的替加环素在该人群中的有效性和安全性。研究设计和方法：回顾性队列研究192例Child-Pugh C级肝衰竭患者，分为标签剂量组（LD）、标准剂量组（SD）和HD组。主要和次要结局包括微生物根除、死亡率和不良反应。结果：SD组的微生物根除率高于LD组，其疗效与HD组相当，但不良事件（如纤维蛋白原需求）较少。高剂量治疗增加了死亡风险（危险比：1.85,p = 0.062）。SD组在治疗第7天出现了最佳的微生物根除和最小的不良反应。结论：标准剂量替加环素提供了一种平衡的微生物根除和安全性的方法，使其更适合肝功能衰竭患者。

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来源期刊

Expert Review of Anti-infective Therapy 医学-药学

CiteScore

11.20

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anti-Infective Therapy (ISSN 1478-7210) provides expert reviews on therapeutics and diagnostics in the treatment of infectious disease. Coverage includes antibiotics, drug resistance, drug therapy, infectious disease medicine, antibacterial, antimicrobial, antifungal and antiviral approaches, and diagnostic tests.