OBJECTIVE To evaluate the changes in coagulation function and to investigate potential influencing factors for new-onset bleeding events in critically ill patients treated with eravacycline.

METHODS Data from critically ill patients who received eravacycline anti-infective therapy in the intensive care unit were retrospectively collected. Coagulation parameters before and after treatment were compared, and Logistic regression analysis was used to identify independent risk factors for new-onset bleeding events.

RESULTS Forty-nine patients were finally enrolled. At baseline, before eravacycline administration, coagulation abnormalities were observed as decreased fibrinogen(FIB) in 10.20% of patients, prolonged prothrombin time(PT) in 59.18%, and reduced platelet count(PLT) in 22.45%; baseline bleeding events were present in 20.41% of patients. Compared with baseline values, FIB levels significantly decreased after eravacycline treatment(P<0.001), PT was significantly prolonged(P=0.002), and PLT showed a slight reduction that did not reach statistical significance. Logistic regression analysis showed that the decrease of platelet count below the normal range or more than 50% compared with the baseline after the treatment with eravacycline was an independent risk factor for new-onset bleeding eventsodds ratio(OR) 18.40, 95% confidence interval(CI) 1.79–189.43, P=0.014, and the treatment course of eravacycline for more than 2 weeks might also increase the risk of new-onset bleeding(OR 10.72, 95%CI 0.98–117.88, P=0.052).

CONCLUSION Eravacycline use in critically ill patients may cause coagulation abnormalities, such as FIB reduction and PT prolongation. A decline in PLT count following eravacycline administration or the treatment course exceeding 2 weeks should prompt vigilance for the risk of new-onset bleeding events.