Hagiya Hideharu, Miyawaki Koji, Yamamoto Norihisa, Yoshida Hisao, Kitagawa Akihiro, Asaoka Tadafumi, Eguchi Hidetoshi, Akeda Yukihiro, Tomono Kazunori
Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, Japan.
Department of Pharmacy, Osaka University Hospital, Japan.
Intern Med. 2017 Nov 15;56(22):3103-3107. doi: 10.2169/internalmedicine.8774-16. Epub 2017 Sep 25.
Ceftriaxone is a widely used third-generation cephalosporin showing advantageous pharmacokinetic properties and a broad antimicrobial spectrum. We herein report a case of ceftriaxone-induced neurotoxicity in a 56-year-old man on hemodialysis. Seven days after initiating high-dose ceftriaxone, the patient developed impaired consciousness along with facial myoclonus and sporadic phonation. The symptoms clearly disappeared shortly after withdrawal of the drug. Ceftriaxone is considered a safe antibiotic for patients with renal insufficiency, since it is excreted via both haptic and renal pathways. Physicians should note that antibiotic-associated encephalopathy may develop in patients administered ceftriaxone, especially in those complicated with renal dysfunction.
头孢曲松是一种广泛使用的第三代头孢菌素,具有良好的药代动力学特性和广泛的抗菌谱。我们在此报告一例56岁接受血液透析男性患者发生头孢曲松诱导的神经毒性病例。在开始使用大剂量头孢曲松7天后,患者出现意识障碍,伴有面部肌阵挛和偶发发声。停药后不久症状明显消失。头孢曲松被认为对肾功能不全患者是一种安全的抗生素,因为它通过肝脏和肾脏两条途径排泄。医生应注意,使用头孢曲松的患者可能会发生抗生素相关性脑病,尤其是那些合并肾功能不全的患者。