Factors linked to tigecycline-associated acute pancreatitis in a multicenter retrospective nested case-control study in patients

Tigecycline is associated with acute pancreatitis (TAAP), yet clinical factors linked to this adverse event require further identification. We conducted a multicenter, retrospective nested case-control study of 6942 patients receiving tigecycline. Cases were defined as patients who developed TAAP, while controls were matched in a 1:4 ratio by the same center and age. Among the cohort, 52 patients developed TAAP with an incidence of 0.75%. The median duration of tigecycline treatment was 7.5 days (IQR: 4-12.25 days), and the median time from the initiation of tigecycline to the onset of acute pancreatitis was 4 days (IQR: 1-8 days) in the case group. Multivariate analysis identified several factors associated with TAAP, including organ transplantation, elevated serum phosphorus, serum urea, aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio, serum gamma-glutamyl transferase (GGT), and concomitant use of esomeprazole; however, protopathic bias cannot be excluded. Our findings identified higher-risk individuals and support more cautious use during tigecycline therapy.