Prolonged course of eravacycline leading to acute pancreatitis

Am J Med Sci. 2023 Dec;366(6):464-467. doi: 10.1016/j.amjms.2023.09.012. Epub 2023 Sep 15.

Abstract

Eravacycline is the newest member of the broad-spectrum class of tetracycline antimicrobials. Pancreatitis has been previously associated with the tetracycline class of antibiotics, but, to our knowledge, we believe that this is the first reported case of eravacycline-induced pancreatitis. We describe a 46-year-old male who received eravacycline for treatment of a perirectal abscess. While the patient had slightly elevated lipase levels at baseline post-cardiopulmonary arrest, he developed abdominal pain and a further increase in lipase levels following 10 days of eravacycline, consistent with pancreatitis. Based on the Naranjo adverse drug reaction probability scale, eravacycline was the probable etiology of acute pancreatitis given improvement immediately after discontinuation. Clinicians should be aware of this potential adverse effect of eravacycline and should not initiate eravacycline in those with risk factors for acute pancreatic injury. However, acute pancreatitis should be suspected in all patients complaining of symptoms followed by immediate discontinuation of eravacycline.

Keywords: Acute pancreatitis; Adverse drug event; Eravacycline; Tetracycline.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acute Disease
  • Anti-Bacterial Agents / adverse effects
  • Humans
  • Lipase / adverse effects
  • Male
  • Middle Aged
  • Pancreatitis* / chemically induced
  • Tetracycline / adverse effects
  • Tetracyclines / adverse effects

Substances

  • eravacycline
  • Anti-Bacterial Agents
  • Tetracyclines
  • Tetracycline
  • Lipase