Department of Internal Medicine I - Cardiology, Nephrology and Internal Intensive Medicine Brandenburg University Hospital, Brandenburg Medical School (Theodor Fontane), Brandenburg an der Havel, Germany.
Faculty of Health Sciences (FGW), Joint Faculty of the University of Potsdam, the Brandenburg Medical School Theodor Fontane and the Brandenburg Technical University Cottbus-Senftenberg, Cottbus, Germany.
J Int Med Res. 2024 Aug;52(8):3000605241253447. doi: 10.1177/03000605241253447.
The aim of this narrative review was to discuss the literature on β-lactam antibiotic-associated hypokalemia, a potentially life-threatening electrolyte disorder. The PubMed, Web of Science, Cochrane Library, and Scopus databases were searched for articles published between 1965 and 2023, using the following terms: 'hypokalemia' OR 'potassium loss' OR 'potassium deficiency' AND 'beta-lactams' OR 'penicillin' OR 'penicillin G' OR 'cephalosporins' OR 'ceftazidime' OR 'ceftriaxone' OR 'flucloxacillin' OR 'carbapenems' OR 'meropenem' OR 'imipenem' OR 'cefiderocol' OR 'azlocillin' OR 'ticarcillin'. Additional search terms were 'hypokalemia' AND 'epidemiology' AND 'ICU' OR 'intensive care unit' OR 'ER' OR 'emergency department' OR 'ambulatory' OR 'old' OR 'ageing population', and experimental (animal-based) studies were excluded. A total of eight studies were selected and discussed, in addition to nine case reports and case series. Both older and currently used β-lactam antibiotics (e.g., ticarcillin and flucloxacillin, respectively) have been associated with therapy-related hypokalemia. The incidence of β-lactam antibiotic-associated hypokalemia may be as high as 40%, thus, the issue of β-lactam-associated hypokalemia remains clinically relevant. Although other causes of hypokalemia are likely to be diagnosed more frequently (e.g., due to diuretic therapy or diarrhea), the possibility of β-lactam-induced renal potassium loss should always be considered in individuals with so-called 'unexplained hypokalemia'.
本综述旨在讨论与β-内酰胺类抗生素相关的低钾血症文献，这是一种潜在危及生命的电解质紊乱。使用以下术语在 1965 年至 2023 年间检索了 PubMed、Web of Science、Cochrane 图书馆和 Scopus 数据库中的文章：“hypokalemia”或“钾损失”或“钾缺乏”和“β-内酰胺类”或“青霉素”或“青霉素 G”或“头孢菌素”或“头孢他啶”或“头孢曲松”或“氟氯西林”或“碳青霉烯类”或“美罗培南”或“亚胺培南”或“头孢地尔”或“阿洛西林”或“替卡西林”。还使用了“hypokalemia”和“epidemiology”和“ICU”或“重症监护病房”或“ER”或“急诊室”或“ambulatory”或“old”或“ageing population”作为额外的搜索词，排除了实验（基于动物）研究。除了九份病例报告和病例系列外，还选择并讨论了八项研究。较老的和当前使用的β-内酰胺类抗生素（例如，分别为替卡西林和氟氯西林）都与治疗相关的低钾血症有关。β-内酰胺类抗生素相关性低钾血症的发生率可能高达 40%，因此，β-内酰胺相关性低钾血症的问题在临床上仍然很重要。尽管其他低钾血症的原因可能更频繁地被诊断（例如，由于利尿剂治疗或腹泻），但对于所谓的“不明原因的低钾血症”患者，始终应考虑β-内酰胺类药物引起的肾钾丢失的可能性。
