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Gastrointestinal risk profile of tigecycline, omadacycline and eravacycline: Evidence from the FDA adverse event reporting system Cover

Gastrointestinal risk profile of tigecycline, omadacycline and eravacycline: Evidence from the FDA adverse event reporting system

By: Zhu Wang,  Guoping Gan and  Haiping Yao  
Open Access
|Dec 2025

References

  1. T. H. Grossman, Tetracycline antibiotics and resistance, Cold Spring Harbor Perspect. Med. 6(4) (2016) Article ID a025387 (24 pages); https://doi.org/10.1101/cshperspect.a025387
  2. K. L. LaPlante, A. Dhand, K. Wright and M. Lauterio, Re-establishing the utility of tetracycline-class antibiotics for current challenges with antibiotic resistance, Ann. Med. 54(1) (2022) 1686–1700; https://doi.org/10.1080/07853890.2022.2085881
  3. H. G. Colaco, A. Barros, A. Neves-Costa, E. Seixas, D. Pedroso, T. Velho, K. L. Willmann, P. Faisca, G. Grabmann, H. S. Yi, M. Shong, V. Benes, S. Weis, T. Kocher and L. F. Moita, Tetracycline antibiotics induce host-dependent disease tolerance to infection, Immunity 54(1) (2021) 53–67; https://doi.org/10.1016/j.immuni.2020.09.011
  4. G. G. Zhanel, J. Esquivel, S. Zelenitsky, C. K. Lawrence, H. J. Adam, A. Golden, R. Hink, L. Berry, F. Schweizer, M. A. Zhanel, D. Bay, P. R. S. Lagace-Wiens, A. J. Walkty, J. P. Lynch, 3rd and J. A. Karlowsky, Omadacycline: A novel oral and intravenous aminomethylcycline antibiotic agent, Drugs 80(3) (2020) 285–313; https://doi.org/10.1007/s40265-020-01257-4
  5. P. Y. Huang, C. K. Hsu, H. J. Tang and C. C. Lai, Eravacycline: A comprehensive review of in vitro activity, clinical efficacy, and real-world applications, Expert Rev. Anti Infect. Ther. 22(6) (2024) 387–398; https://doi.org/10.1080/14787210.2024.2351552
  6. S. Yaghoubi, A. O. Zekiy, M. Krutova, M. Gholami, E. Kouhsari, M. Sholeh, Z. Ghafouri and F. Maleki, Tigecycline antibacterial activity, clinical effectiveness, and mechanisms and epidemiology of resistance: Narrative review, Eur. J. Clin. Microbiol. Infect. Dis. 41(7) (2021) 1003–1022; https://doi.org/10.1007/s10096-020-04121-1
  7. Tigecycline FDA Label, revised 4/2025; https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/dd58e0c3-d8a8-4cf2-96f8-9dd08f309579/spl-doc?hl=tigecycline; last access date July 31, 2025
  8. Omadacycline FDA Label, revised 3/2025; https://nctr-crs.fda.gov/fdalabel/services/spl/setids/51591524-4703-44c6-8bde-dce3e6a463d1/spl-doc?hl=omadacycline; last access date July 31, 2025.
  9. Eravacycline FDA Label, revised 3/2025; https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/a4b188d4-f467-470c-ad7b-25ffbdd8862a/spl-doc?hl=eravacycline; last access date July 31, 2025.
  10. Q. Kaewpoowat and L. Ostrosky-Zeichner, Tigecycline: A critical safety review, Expert Opin. Drug Saf. 14(2) (2015) 335–342; https://doi.org/10.1517/14740338.2015.997206
  11. F. Lin, R. He, B. Yu, B. Deng, B. Ling and M. Yuan, Omadacycline for treatment of acute bacterial infections: A meta-analysis of phase II/III trials, BMC Infect. Dis. 23(1) (2023) Article ID 232 (10 pages); https://doi.org/10.1186/s12879-023-08212-0
  12. R. Meng, X. Guan, L. Sun, Z. Fei, Y. Li, M. Luo, A. Ma and H. Li, The efficacy and safety of eravacycline compared with current clinically common antibiotics in the treatment of adults with complicated intra-abdominal infections: A Bayesian network meta-analysis, Front. Med. (Lausanne) 9 (2022) Article ID 935343 (15 pages); https://doi.org/10.3389/fmed.2022.935343
  13. K. Eljaaly, J. K. Ortwine, M. Shaikhomer, T. A. Almangour and M. Bassetti, Efficacy and safety of eravacycline: A meta-analysis, J. Glob. Antimicrob. Resist. 24 (2021) 424–428; https://doi.org/10.1016/j.jgar.2021.02.009
  14. S. H. Lan, S. P. Chang, C. C. Lai, L. C. Lu and C. M. Chao, The efficacy and safety of omadacycline in treatment of acute bacterial infection: A systemic review and meta-analysis of randomized controlled trials, Medicine (Baltimore) 98(51) (2019) e18426 (6 pages); https://doi.org/10.1097/MD.0000000000018426
  15. P. Inácio, A. Cavaco and M. Airaksinen, The value of patient reporting to the pharmacovigilance system: A systematic review, Br. J. Clin. Pharmacol. 83(2) (2017) 227–246; https://doi.org/10.1111/bcp.13098
  16. T. Sakaeda, A. Tamon, K. Kadoyama and Y. Okuno, Data mining of the public version of the FDA Adverse Event Reporting System, Int. J. Med. Sci. 10(7) (2013) 796–803; https://doi.org/10.7150/ijms.6048
  17. E. G. Brown, L. Wood and S. Wood, The medical dictionary for regulatory activities (MedDRA), Drug Saf. 20(2) (1999) 109–117; https://doi.org/10.2165/00002018-199920020-00002
  18. E. P. van Puijenbroek, A. Bate, H. G. Leufkens, M. Lindquist, R. Orre and A. C. Egberts, A comparison of measures of disproportionality for signal detection in spontaneous reporting systems for adverse drug reactions, Pharmacoepidemiol. Drug Saf. 11(1) (2002) 3–10; https://doi.org/10.1002/pds.668
  19. C. Khouri, T. Nguyen, B. Revol, M. Lepelley, A. Pariente, M. Roustit and J. L. Cracowski, Leveraging the variability of pharmacovigilance disproportionality analyses to improve signal detection performances, Front. Pharmacol. 12(1) (2021) Article ID 668765 (7 pages); https://doi.org/10.3389/fphar.2021.668765
  20. K. J. Rothman, S. Lanes and S. T. Sacks, The reporting odds ratio and its advantages over the proportional reporting ratio, Pharmacoepidemiol. Drug Saf. 13(8) (2004) 519–523; https://doi.org/10.1002/pds.1001
  21. A. Kumar, The newly available FAERS public dashboard: Implications for health care professionals, Hosp. Pharm. 54(2) (2019) 75–77; https://doi.org/10.1177/0018578718795271
  22. L. Wang, D. Liu, Y. Lv, L. Cui, Y. Li, T. Li, H. Song, Y. Hao, J. Shen, Y. Wang and T. R. Walsh, Novel plasmid-mediated tet(X5) gene conferring resistance to tigecycline, eravacycline, and omadacycline in a clinical Acinetobacter baumannii isolate, Antimicrob. Agents Chemother. 64(1) (2019) Article ID 10.1128/AAC.01326-19 (5 pages); https://doi.org/10.1128/AAC.01326-19
  23. A. J. Kunz Coyne, S. Alosaimy, K. Lucas, A. M. Lagnf, T. Morrisette, K. C. Molina, A. DeKerlegand, M. R. Schrack, S. L. Kang-Birken, A. L. V. Hobbs, J. Agee, N. B. Perkins, M. Biagi, M. Pierce, J. Truong, J. Andrade, J. Bouchard, T. Gore, M. A. King, B. M. Pullinger, K. C. Claeys, S. Herbin, R. Cosimi, S. Tart, M. P. Veve, B. M. Jones, L. M. Rojas, A. K. Feehan, M. R. Scipione, J. J. Zhao, P. Witucki, M. J. Rybak and A. Babiker, Eravacycline, the first four years: health outcomes and tolerability data for 19 hospitals in 5 U.S. regions from 2018 to 2022, Microbiol. Spectr. 12(1) (2024) e0235123 (14 pages); https://doi.org/10.1128/spectrum.02351-23
  24. J. Rello, Pharmacokinetics, pharmacodynamics, safety and tolerability of tigecycline, J. Chemother. 17(Suppl. 1) (2005) 12–22; https://doi.org/10.1179/joc.2005.17.Supplement-1.12
  25. L. A. Bundrant, E. Tzanis, L. Garrity-Ryan, S. Bai, S. Chitra, A. Manley and S. Villano, Safety and pharmacokinetics of the aminomethylcycline antibiotic omadacycline administered to healthy subjects in oral multiple-dose regimens, Antimicrob. Agents Chemother. 62(2) (2018) Article ID 10.1128/AAC.01487-17 (9 pages); https://doi.org/10.1128/AAC.01487-17
  26. J. Ren, Y. Zheng, H. Du, S. Wang, L. Liu, W. Duan, Z. Zhang, L. Heng and Q. Yang, Antibiotic-- induced black hairy tongue: Two case reports and a review of the literature, J. Int. Med. Res. 48(10) (2020) Article ID 300060520961279 (11 pages); https://doi.org/10.1177/0300060520961279
  27. N. Shaheen and D. F. Ransohoff, Gastroesophageal reflux, Barrett esophagus, and esophageal cancer: Scientific review, JAMA 287(15) (2002) 1972–1981; https://doi.org/10.1001/jama.287.15.1972
  28. J. S. Overcash, P. Bhiwandi, L. Garrity-Ryan, J. Steenbergen, S. Bai, S. Chitra, A. Manley and E. Tzanis, Pharmacokinetics, safety, and clinical outcomes of omadacycline in women with cystitis: Results from a phase 1b study, Antimicrob. Agents Chemother. 63(5) (2019) Article ID 10.1128/AAC.02083-18 (10 pages); https://doi.org/10.1128/AAC.02083-18
  29. H. Arafat, D. Sadaqa and A. Sabateen, Tigecycline-induced pancreatitis in a patient with recurrent malignancy: A case report and literature review, Ann. Med. Surg. (London) 86(6) (2024) 3717–3720; https://doi.org/10.1097/MS9.0000000000002077
  30. B. S. Maringanti, V. M. Ganipisetti, S. S. Jun and M. I. Flores, Tigecycline tango: a case of antibiotic-induced pancreatitis, Cureus 15(9) (2023) e44538 (3 pages); https://doi.org/10.7759/cureus.44538
  31. S. Opal, T. M. File, T. van der Poll, E. Tzanis, S. Chitra and P. C. McGovern, An integrated safety summary of omadacycline, a novel aminomethylcycline antibiotic, Clin. Infect. Dis. 69(Suppl. 1) (2019) S40–S47; https://doi.org/10.1093/cid/ciz398
  32. C. M. Mingora, W. Bullington, P. E. Faasuamalie, A. Levin, G. Porter, R. Stadnick, C. D. Varley, D. Addrizzo-Harris, C. L. Daley, K. N. Olivier, K. L. Winthrop, S. E. Dorman and P. A. Flume, Long-term safety and tolerability of omadacycline for the treatment of mycobacterium abscessus infections, Open Forum Infect. Dis. 10(7) (2023) Article ID ofad335 (6 pages); https://doi.org/10.1093/ofid/ofad335
  33. P. C. McGovern, M. Wible, J. M. Korth-Bradley and A. Quintana, Pancreatitis in tigecycline Phase 3 and 4 clinical studies, J. Antimicrob. Chemother. 69(3) (2014) 773–778; https://doi.org/10.1093/jac/dkt427
  34. N. Cui, H. Cai, Z. Li, Y. Lu, G. Wang and A. Lu, Tigecycline-induced coagulopathy: A literature review, Int. J. Clin. Pharm. 41(6) (2019) 1408–1413; https://doi.org/10.1007/s11096-019-00912-5
  35. H. Pieringer, B. Schmekal, G. Biesenbach and E. Pohanka, Severe coagulation disorder with hypofibrinogenemia associated with the use of tigecycline, Ann. Hematol. 89(10) (2010) 1063–1064; https://doi.org/10.1007/s00277-010-0911-7
  36. Q. Fan, W. Huang, Y. Weng, X. Xie and Z. Shi, Hypofibrinogenemia induced by high-dose tigecycline-case report and review of literature, Medicine (Baltimore) 99(43) (2020) e22638 (5 pages); https://doi.org/10.1097/MD.0000000000022638
  37. H. Duan, L. Yu, F. Tian, Q. Zhai, L. Fan and W. Chen, Antibiotic-induced gut dysbiosis and barrier disruption and the potential protective strategies, Crit. Rev. Food Sci. Nutr. 62(6) (2022) 1427–1452; https://doi.org/10.1080/10408398.2020.1843396
  38. B. E. Dawes, J. Gao, C. Atkins, J. T. Nelson, K. Johnson, P. Wu and A. N. Freiberg, Human neural stem cell-derived neuron/astrocyte co-cultures respond to La Crosse virus infection with proinflammatory cytokines and chemokines, J. Neuroinflammation 15(1) (2018) Article ID 315 (15 pages); https://doi.org/10.1186/s12974-018-1356-5
  39. S. Andrei, G. Droc and G. Stefan, FDA approved antibacterial drugs: 2018–2019, Discoveries (Craiova) 7(4) (2019) e102 (11 pages); https://doi.org/10.15190/d.2019.15
  40. L. Vidal, I. Ben Dor, M. Paul, N. Eliakim-Raz, E. Pokroy, K. Soares-Weiser and L. Leibovici, Oral versus intravenous antibiotic treatment for febrile neutropenia in cancer patients, Cochrane Database Syst. Rev. (10) (2013) Article ID CD003992 (66 pages); https://doi.org/10.1002/14651858.CD003992.pub3
  41. H. K. Li, M. Scarborough, R. Zambellas, C. Cooper, I. Rombach, A. S. Walker, B. A. Lipsky, A. Briggs, A. Seaton, B. Atkins, A. Woodhouse, A. Berendt, I. Byren, B. Angus, H. Pandit, D. Stubbs, M. McNally, G. Thwaites and P. Bejon, Oral versus intravenous antibiotic treatment for bone and joint infections (OVIVA): Study protocol for a randomised controlled trial, Trials 16 (2015) Article ID 583 (12 pages); https://doi.org/10.1186/s13063-015-1098-y
  42. S. Villano, J. Steenbergen and E. Loh, Omadacycline: development of a novel aminomethylcycline antibiotic for treating drug-resistant bacterial infections, Future Microbiol. 11(1) (2016) 1421–1434; https://doi.org/10.2217/fmb-2016-0100
  43. S. Lucas, J. Ailani, T. R. Smith, A. Abdrabboh, F. Xue and M. S. Navetta, Pharmacovigilance: Reporting requirements throughout a product’s lifecycle, Ther. Adv. Drug Saf. 13(1) (2022) Article ID 20420986221125006 (16 pages); https://doi.org/10.1177/20420986221125006
  44. K. Staller, H. P. Parkman, K. B. Greer, D. A. Leiman, M. J. Zhou, S. Singh, M. Camilleri, O. Altayar (on behalf of the AGA Clinical Guidelines Committee), AGA clinical practice guideline on management of gastroparesis, Gastroenterology 169(5) (2025) 828–861; https://doi.org/10.1053/j.gastro.2025.08.004
DOI: https://doi.org/10.2478/acph-2026-0001 | Journal eISSN: 1846-9558 | Journal ISSN: 1330-0075
Language: English
Accepted on: Nov 24, 2025
Published on: Dec 17, 2025
Published by: Croatian Pharmaceutical Society
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
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© 2025 Zhu Wang, Guoping Gan, Haiping Yao, published by Croatian Pharmaceutical Society
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

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