替加环素相关急性胰腺炎

替加环素(tigecycline)是一种新型广谱抗生素,为甘氨酰环素类(glycyclines)抗生素的首个药物,其化学结构与四环素相似.替加环素对革兰阳性菌和革兰阴性菌具有抗菌活性,用于治疗复杂皮肤、软组织感染和复杂腹腔内感染.通常,替加环素偶致急性胰腺炎,但近年资料表明,替加环素致急性胰腺炎有所增加.临床表现主要为恶心、呕吐、腹痛、腹胀以及血清脂肪酶和淀粉酶水平升高.替加环素致胰腺炎的机制尚不明确,但由于替加环素的结构与四环素结构相似,推测替加环素是通过四环素致胰腺炎的同样机制引起急性胰腺炎.替加环素若引起胰腺炎,应立即停药,保持患者禁食状态,静脉给予足量液体,并给予其他对症治疗.替加环素使用期间,临床医师应密切观察患者有无胰腺炎的症状和体征,监测患者的血清脂肪酶和淀粉酶水平.

Acute pancreatitis associated with tigecycline

Tigecycline is a new broad-spectrum antibiotic.This antibiotic is the first clinically available drug in glycyclines.It is structurally similar to tetracycline.Tigecycline is active against Gram-positive and Gram-negative bacteria and is used for treatment of complicated skin and soft tissue infections and complicated intra-abdominal infections.Generally,tigecycline less commonly causes acute pancreatitis.However,recent data indicate that tigecycline-induced acute pancreatitis has somewhat increased.The clinical presentation of tigecycline-induced acute pancreatitis is nausea,vomiting,abdominal pain,abdominal distension,and elevation in serum lipase and amylase levels.The mechanism of pancreatitis caused by tigecyclins remains unclear,but because of the structural similarity between tigecycline and tetracycline,it is plausible that tigecycline may be via the same mechanism as tetracycline to precipitate an acute episode of pancreatitis.If pancreatitis is considered to be caused by tigecycline,prompt discontinuation of tigecycline therapy is necessary.The management of tigecycline-induced pancreatitis includes administration of IV fluids,avoidance of food,and other symptomatic treatments.Clinicians should observe patients for signs and symptoms of pancreatitis,and monitor serum lipase and amylase levels during treatment with tigecycline.