Retrospective exploration of the impact of proton pump inhibitors on the clinical efficacy of tigecycline
Objective To investigate whether the use of proton pump inhibitors(PPIs)affects the clinical efficacy of tigecycline,and to provide clinical evidence for the combination of tigecycline and PPIs,thereby ex-ploring better clinical drug selection options.Methods A retrospective analysis was conducted on the clinical data of patients treated with tigecycline for anti-infection in Inner Mongolia People's Hospital from January 2020 to December 2023.Based on inclusion and exclusion criteria,a total of 306 patients were selected:161 patients in the tigecycline combined with proton pump inhibitors group(T+P group)and 145 patients in the tigecycline without proton pump inhibitors group(T group).The main outcomes included all-cause mortality and clinical efficacy.Sec-ondary outcomes included length of hospital stay,body temperature,and microbial clearance rate.Logistic regres-sion analysis was used to examine independent factors affecting clinical efficacy.Results The clinical effective rate in T+P group was lower than that in the T group(37.3％vs 49.7％),and the difference was statistically signifi-cant(x2=4.77,P=0.03).The average body temperature after treatment in the T+P group was higher than that in the T group[(37.1±0.8℃)vs(36.9±0.7℃)],and the difference was statistically significant(P=0.04).There was no statistical difference in all-cause mortality,microbiological clearance rate and hospital stay between the two groups.Multivariate Logistic regression analysis revealed that the combination of tigecycline and PPIs was an in-dependent risk factor affecting clinical efficacy[OR(95％CI):0.45(0.27,0.76),P＜0.01],suggesting that the proba-bility of clinical efficacy when tigecycline was combined with PPIs was 0.45 times that of tigecycline alone.The probability of gastrointestinal adverse reactions in the T+P group was higher than that in the T group(23.6％vs 13.8％),and the difference was statistically significant(P=0.03),while there was no difference in coagulation dysfunction between the two groups of patients.Conclusion The co-administration of PPIs during tigecycline anti-infection therapy may reduce clinical efficacy,but the specific mechanism remains unclear.Therefore,caution should be exercised when using PPIs in combination with tigecycline for anti infective treatment in clinical practice.
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