Occurrence of hepatic dysfunction and the influencing factors among preadult inpatients treated with imipenem-cilastatin sodium
10.3760/cma.j.issn.1008-5734.2017.05.007
- VernacularTitle:亚胺培南西司他丁钠致未成年住院患者肝功能异常发生情况及影响因素分析
- Author:
Le ZOU
1
;
Tao YIN
;
Shiqin HUANG
;
Ying ZHU
Author Information
1. 中南大学湘雅医院药学部, 长沙,410008
- Publication Type:Journal Article
- Keywords:
Imipenem;
Drug-induced liver injury;
Minors
- From:
Adverse Drug Reactions Journal
2017;19(5):353-358
- CountryChina
- Language:Chinese
-
Abstract:
Objective To understand the occurrence of hepatic dysfunction induced by imipenem-cilastatin sodium in preadult inpatients and analyze the influencing factors. Methods Data of inpatients receiving imipenem-cilastatin sodium treatment in Xiangya Hospital of Central South University from January 1st,2016 to December 31st,2016 were collected and analyzed retrospectively. The patients′ general condition,utilization of imipenem-cilastatin sodium,combined medication,clinical effect,and liver function etc. were recorded. The influencing factors of hepatic dysfunction,especially severe liver injury caused by imipenem-cilastatin sodium were analyzed. Results A total of 143 preadult inpatients were enrolled into this study. Of them,86 patients were males and 57 were females;61 of them were <1 year old,9 were 1-3 years old,6 were 4-10 years old,67 of them were 11-18 years old,and their median age was 9 years. There were 176 infections in the 143 patients. Most of the infections were respiratory tract infection,sepsis, and septicemia. Imipenem-cilastatin sodium was given via intravenous infusion in all patients. At the same daily dosage,the drug was given every 6 hours in 30 patients(21.0%),every 8 hours in 79 patients (55.2%),every 12 hours in 31 patients(21.7%),once daily in 3 patients(2.1%). Eighty-five patients were given combined drugs that could cause liver dysfunction,such as vancomycin,voriconazole, fluconazole,and azithromycin etc. Of the 143 patients,59 had hepatic dysfunction(41.3%),24 had liver injury(16.8%),and 11 had severe liver injury(7.7%). Thirty-four patients with hepatic dysfunction received drugs that could cause liver dysfunction during the imipenem-cilastatin sodium treatment. Occurrence of liver dysfunction was not correlated with any of the following factors:patients′ gender,ages, whether or not having malignant tumor,systemic infections,frequency of administration at the same daily dosage,combination drugs that could cause liver dysfunction,liver-protective drugs use before imipenem-cilastatin sodium treatment(all P>0.05). However,the difference in the incidence of severe liver injury between the <1 year old and 11-18 years old patients was statistically significant[18.0%(11/61)vs. 0(0/67),P<0.001],the difference in the incidence of severe liver injury between the inpatients with malignancies or not was statistically significant[0(0/46)vs. 11.3%(11/97),P<0.01],the difference in the incidence of severe liver injury between the inpatients whose administration frequency was every 6 hours and once daily was statistically significant[0(0/30)vs. 1/3,P=0.001]. Conclusions Non-adult inpatients who were treated with imipenem-cilastatin sodium were prone to develop hepatic dysfunction. Inpatients at age <1 year or receiving higher single dose are more likely to have severe liver injury.
