Iwabuchi F, Shimada A, Nagura Y, Takahashi S, Hatano M
Second Department of Internal Medicine, Nihon University School of Medicine, Tokyo.
Drugs. 1988;35 Suppl 2:181-4. doi: 10.2165/00003495-198800352-00038.
A study was conducted of the effects of cefotaxime, a third generation cephalosporin antibiotic, on the function of the kidney, using several indices of renal function including urinary concentrations of the renal enzyme N-acetyl-beta-D-glucosaminidase (NAG). In 6 patients with respiratory infections and normal renal function (group I), the urinary concentrations of NAG before and after the administration of cefotaxime 2 to 4g daily were 5.7 +/- 0.6 U/L and 5.5 +/- 0.9 U/L, respectively (NS). Similarly, 9 patients with chronic renal failure who were not undergoing haemodialysis showed pre- and post-treatment urinary NAG concentrations of 8.7 +/- 4.0 U/L and 6.6 +/- 1.7 U/L, respectively (NS), while the corresponding values in 12 renally impaired patients undergoing haemodialysis (group III) were 8.1 +/- 3.5 U/L and 8.9 +/- 3.8 U/L, respectively (NS). With regard to other parameters of renal function (serum creatinine, BUN, beta 2M, and creatinine clearance), no statistically significant differences were found between the values obtained before and after therapy with cefotaxime. Therefore, it was concluded that the influence of cefotaxime on renal function is slight, and that this antibiotic can be safely used to treat patients with infections in the presence of renal dysfunction.
一项关于第三代头孢菌素抗生素头孢噻肟对肾功能影响的研究展开，该研究使用了包括肾酶N-乙酰-β-D-氨基葡萄糖苷酶（NAG）尿浓度在内的多项肾功能指标。在6例呼吸道感染且肾功能正常的患者（I组）中，每日给予2至4克头孢噻肟前后的尿NAG浓度分别为5.7±0.6 U/L和5.5±0.9 U/L（无统计学差异）。同样，9例未进行血液透析的慢性肾衰竭患者治疗前和治疗后的尿NAG浓度分别为8.7±4.0 U/L和6.6±1.7 U/L（无统计学差异），而12例接受血液透析的肾损害患者（III组）的相应值分别为8.1±3.5 U/L和8.9±3.8 U/L（无统计学差异）。关于其他肾功能参数（血清肌酐、血尿素氮、β2微球蛋白和肌酐清除率），头孢噻肟治疗前后获得的值之间未发现统计学上的显著差异。因此，得出的结论是头孢噻肟对肾功能的影响轻微，并且这种抗生素可安全用于治疗存在肾功能不全的感染患者。
