Liao Pei-Fei, Wu Yao-Kuang, Huang Kuo-Liang, Chen Hsin-Yi
Department of Pharmacy, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.
Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.
Tzu Chi Med J. 2019 Apr-Jun;31(2):124-128. doi: 10.4103/tcmj.tcmj_151_18.
Cefepime is widely used in the hospital setting, and only a few studies have reported neurotoxicity and nephrotoxicity as side effects of this drug. Herein, we present a 93-year-old man who exhibited features of cholestatic hepatitis including elevated blood transaminases and direct-form predominant bilirubin levels after administration of cefepime. Blood liver tests showed total recovery after discontinuing the offending agent. Cefepime was probable to cause drug-induced cholestatic hepatitis in our patient since the Roussel Uclaf Causality Assessment Method score for cefepime was 7. No drug interactions were likely according to the Drug Interaction Probability Scale for this patient. No similar cases of cholestatic drug-induced liver injury related to cefepime have been reported previously. Hence, this rare condition requires a high degree of clinical suspicion for prompt diagnosis and treatment.
头孢吡肟在医院环境中广泛使用,仅有少数研究报告该药物的副作用为神经毒性和肾毒性。在此,我们报告一名93岁男性,在使用头孢吡肟后出现胆汁淤积性肝炎的特征,包括血液转氨酶升高和直接胆红素水平为主。肝脏血液检查显示停用致病药物后完全恢复。由于头孢吡肟的鲁塞尔·优克福因果关系评估法评分为7分,因此头孢吡肟很可能导致了我们患者的药物性胆汁淤积性肝炎。根据该患者的药物相互作用概率量表,不太可能存在药物相互作用。此前尚未报告过与头孢吡肟相关的类似药物性胆汁淤积性肝损伤病例。因此,这种罕见情况需要高度的临床怀疑以进行及时诊断和治疗。