Retrospective evaluation of tigecycline use in patients hospitalized in the anesthesiology and reanimation intensive care unit

Aim: The aim of this study is to evaluate laboratory and clinical responses during treatment in patients receiving tigecycline in the intensive care unit, and to examine the relationship between the effectiveness of different dosing regimens and the clinical and sociodemographic characteristics of the patients. Material and method: This retrospective study was conducted on patients who were hospitalized in the Reanimation Intensive Care Unit of İnönü University Turgut Özal Medical Center between January 2022 and December 2024 and received tigecycline treatment. Patients identified through the hospital pharmacy database and whose laboratory and clinical records were accessed via the hospital information management system were included in the study. Patients who received tigecycline treatment, were ≥18 years of age, were hospitalized in the intensive care unit for at least 48 hours, and received tigecycline treatment for at least 72 hours were included in the study. Patients were grouped as those receiving low-dose tigecycline treatment (50 mg, once every 12 hours) and high-dose tigecycline treatment (100 mg, once every 12 hours). Sociodemographic characteristics of the patients, laboratory findings monitored during treatment, and treatment-related data were recorded using a patient follow-up form. Statistical analyses of the data were performed using the SPSS 27.0 software. Results: Of the 145 patients included in the study, 68.3% were male and 31.7% were female, with a mean age of 63.9 ± 18.2 years. Tigecycline treatment was initiated empirically in 66.9% of the patients, and 64.1% received low-dose therapy. When time-dependent changes in laboratory parameters during tigecycline treatment were evaluated, statistically significant changes over time were observed in hemoglobin (HGB), International Normalized Ratio (INR), activated partial thromboplastin time (aPTT), prothrombin time (PT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP) values (p < 0.05). In addition, statistically significant relationships were identified between the first 24 hours of treatment and the 24 hours after the completion of treatment for INR, aPTT, PT, GGT, total bilirubin, and direct bilirubin values (p < 0.05). While time-dependent significant changes were observed in HGB, INR, aPTT, PT, AST, ALT, GGT, total bilirubin, and direct bilirubin values in the low-dose group, only INR and PT values showed significant time-dependent changes in the high-dose group. When time-dependent changes in alkaline phosphatase, platelet count (PLT), serum creatinine, sodium, amylase, and lipase levels were evaluated between the groups, no statistically significant changes were observed in either group (p > 0.05). Conclusion: This study demonstrates that clinically significant and notable changes may occur particularly in coagulation and liver function parameters during tigecycline treatment in intensive care patients, indicating that close laboratory monitoring throughout treatment is essential for patient safety and treatment management. Key words: Infectious diseases, tigecycline, intensive care, clinical pharmacist