Efficacy of piperacillin/tazobactam combined with tigecycline in treatment of cirrhotic patients with ascites infection

Fan Jiani; Chen Bin; Lyu Boqian

doi:10.3969/j.issn.1672-8157.2025.05.020

Abstract：Objective To observe the clinical effect of piperacillin/tazobactam combined with tigecycline on the treatment of cirrhotic patients with ascites infection.Methods The medical records of 106 cirrhotic patients with ascites infection who were admitted to Renji Hospital,Shanghai Jiaotong University School of Medicine from March 2020 to October 2024 were ret-rospectively collected.According to different treatment methods,the patients were divided into the tigecycline group(54 cases)and the combined group(52 cases).The tigecycline group was treated with tigecycline,and the combined group was given pipera-cillin/tazobactam combined with tigecycline.Both groups were treated continuously for 5 weeks.The clinical efficacy,liver function indexes(albumin,alanine aminotransferase and total bilirubin),infection indexes(C-reactive protein,procalcitonin and endotoxin),immune function indexes and incidence of adverse reactions were compared between the two groups before and after 5 weeks of treatment.Results The total effective rate of treatment in the combined group was 94.23%(49/52)after 5 weeks of treatment,higher than 75.93%(41/54)in the tigecycline group(χ2=6.926,P<0.05).After 5 weeks of treatment,the levels of procalcitonin,C-re-active protein and endotoxin in the combined group were(1.85±0.34)ng·mL-1,(5.89±1.64)mg·L-1 and(10.13±3.51)pg·mL-1,respec-tively,lower than(2.32±0.42)ng·mL-1,(7.55±2.18)mg·L-1 and(13.45±3.54)pg·mL-1,respectively in the tigecycline group(t=6.318,4.417,4.847,all P<0.05).After 5 weeks of treatment,the level of albumin in the combined group was(40.85±4.14)g·L-1,higher than(38.43±4.09)g·L-1 in the tigecycline group,and the levels of alanine aminotransferase and total bilirubin were(61.32±4.65)U·L-1 and(12.68±2.27)U·L-1,lower than(65.77±4.83)U·L-1 and(15.42±2.16)U·L-1 in the tigecycline group(t=3.027,4.829,6.368,all P<0.05).After 5 weeks of treatment,the levels of T lymphocyte subpopulations CD3+,CD4+and CD4+/CD8+in the combined group were(53.25±5.71)%,(44.17±3.59)%and(1.81±0.46),higher than(50.83±4.08)%,(41.99±3.85)%and(1.55±0.41)in the tigecycline group(t=2.834,2.580,2.398,all P<0.05).The incidence of adverse reactions in the combined group and the tigecycline group was 13.46%(7/52)and 9.26%(5/54),respectively,and there was no significant difference between the two groups(χ2=0.466,P>0.05).Conclusion Piperacillin/tazobactam combined with tigecycline is effective in the treatment of cirrhotic patients with ascites infec-tion,which can effectively improve liver function,immune function and infection,without increasing adverse reactions.