Yamada Tomoyuki, Mitsuboshi Satoru, Suzuki Kaoru, Nishihara Masami, Neo Masashi
Department of Pharmacy, Osaka Medical and Pharmaceutical University Hospital, 569-8686, Takatsuki, Osaka, Japan.
Infection Control Center, Osaka Medical and Pharmaceutical University Hospital, 569-8686, Takatsuki, Osaka, Japan.
Int J Clin Pharm. 2022 Aug;44(4):1067-1071. doi: 10.1007/s11096-022-01406-7. Epub 2022 Apr 21.
The profile of ceftriaxone-induced encephalopathy is not well understood.
To identify risk factors associated with ceftriaxone-induced encephalopathy.
In this observational study, anonymised patient data were retrieved from the open-access Japanese Adverse Drug Event Report database for ceftriaxone users aged 20 years or higher.
Data of 256,788 individuals and 12,160 cases of encephalopathy were extracted, and 2,939 ceftriaxone users, of whom 193 had encephalopathy, were identified. A disproportionate prevalence of encephalopathy was observed among the ceftriaxone users (reported odds ratio = 1.42; 95% confidence interval [CI] = 1.23-1.65; p < 0.001). Multivariate logistic regression analysis of 2,057 ceftriaxone users showed encephalopathy was associated with female sex (odds ratio [OR] = 1.52; 95% CI, 1.05-2.19; p = 0.027), chronic kidney disease (OR = 2.32; 95% CI, 1.47-3.67; p < 0.001), a ceftriaxone dosage of > 2 g/day (OR = 2.66; 95% CI, 1.66-4.26; p < 0.001), and a treatment duration of > 14 days (OR = 1.94; 95% CI, 1.21-3.11; p = 0.006).
Patients with chronic kidney disease, receiving ceftriaxone at a dosage of > 2 g/day, being treated for over 14 days, and/or females may be at an increased risk of ceftriaxone-induced encephalopathy.
头孢曲松所致脑病的情况尚未完全明确。
确定与头孢曲松所致脑病相关的危险因素。
在这项观察性研究中，从开放获取的日本药品不良事件报告数据库中检索了年龄在20岁及以上的头孢曲松使用者的匿名患者数据。
提取了256,788名个体的数据和12,160例脑病病例，确定了2,939名头孢曲松使用者，其中193人患有脑病。在头孢曲松使用者中观察到脑病的患病率不成比例（报告的比值比=1.42；95%置信区间[CI]=1.23-1.65；p<0.001）。对2,057名头孢曲松使用者进行的多因素逻辑回归分析显示，脑病与女性（比值比[OR]=1.52；95%CI，1.05-2.19；p=0.027）、慢性肾脏病（OR=2.32；95%CI，1.47-3.67；p<0.001）、头孢曲松剂量>2g/天（OR=2.66；95%CI，1.66-4.26；p<0.001）以及治疗持续时间>14天（OR=1.94；95%CI，1.21-3.11；p=0.006）有关。
患有慢性肾脏病、接受剂量>2g/天的头孢曲松治疗、治疗超过十四天和/或女性的患者发生头孢曲松所致脑病的风险可能会增加。
