To investigate the adverse reactions of tigecycline in the treatment of severe pneumonia and the relationship between overdoses and adverse reaction rates.

The data of 100 patients with severe pneumonia receiving tigecycline in the Respiratory Intensive Care Unit (RICU) of the First Affiliated Hospital of Nanjing Medical University from July 2016 to June 2018 were analyzed retrospectively. The patients were divided into a recommended dose group (n=50) and an overdose group (n=50) according to the administration of tigecycline. The general information, clinical information and laboratory examination information were collected and statistically analyzed.

Adverse reactions were observed in 31 cases (31.00%), including skin rash in 1 case, alimentary system reaction in 9, liver function damage in 10, thrombopenia in 10 and liver function damage complicated with thrombopenia in 1. Significant difference of fibrinogen (FIB) was found between the recommended dose group and the overdose group (P<0.05), however, no statistical significant difference was found between the two groups in the other adverse reactions. The incidences of adverse reactions were 30.77% (24/78 case-times) and 40.00% (8/20 case times), respectively, of all the tigecycline takers who were given one or two antibacterials at the same time, but there was no statistical significant difference between the two groups (P>0.05). Before and after use of tigecycline, significant differences were found in the prothrombin time (PT), the activated partial thromboplastin time (APTT), the thrombin time (TT), FIB and the blood urea nitrogen (BUN).

The incidence of adverse reactions was not significantly increased when taking overdose tigecycline. Special attention should be paid to the blood coagulation system, the liver and the renal function and the level of platelets when using tigecycline.