Objective  To systematicly review and analyze the clinical characteristics of tigecycline-induced acute pancreatitis, and provide a basis for the safe application of tigecycline.Methods  Databases of PubMed, Embase, Elsevier, CNKI, WanFang Data and VIP data (from inception to April 30, 2022 ) were searched for case reports published about acute pancreatitis caused by tegacyclin, which were statistically analyzed.

Results  25 literatures were included involving 30 patients, from 8 countries, the median age was 50 years (rang 9-87). The median duration of treatment with tigecycline was 9 days (range 3-56 d), the median duration of symptom onset was 8 days (range 2-28 d), and 3 patients developed acute pancreatitis after 3-28 days of retreatment with tigecycline. Symptoms included nausea, vomiting (67.8%) and abdominal distension and abdominal pain (89.2%). The median levels of amylase and lipase were 539.05 (range 102-21 000)U·L^-1 and 879 (range 156-4 089)U·L^-1. Computed tomography (CT) scans showed localized or diffuse enlargement of the pancreas and inflammatory changes around the pancreas in 70.8% of cases and acute pancreatitis in 25.0% of cases. The median duration of recovery of symptoms was 3 days (range 1-10 d), and the time for recovery of amylase and lipase to the normal range was 5 days (range 1-43 d) after the withdrawal of tigecycline in all patients.

Conclusion  Clinicians should be alert to the acute pancreatitis caused by tegacyclin, if the clinical symptoms of the patient are nausea and vomiting, abdominal distension and abdominal pain, serum amylase, lipase levels and abdominal CT should be monitored to check whether acute pancreatitis is caused when using tigecycline.

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