Acute liver injury caused by meropenem in an infant
10.3760/cma.j.cn114015-20250309-00128
- VernacularTitle:美罗培南致婴儿急性肝损伤
- Author:
Yaqun XIONG
1
;
Fei QI
;
Yan GUO
;
Liu ZENG
Author Information
1. 湘雅常德医院药剂科，常德 415009
- Publication Type:Journal Article
- Keywords:
Meropenem;
Infant;
Cholestasis;
Drug-induced liver injury
- From:
Adverse Drug Reactions Journal
2025;27(9):574-576
- CountryChina
- Language:Chinese
-
Abstract:
A 2-month-old female infant developed fever for 2 days and diarrhea for 1 day. Laboratory tests showed that white blood cell count was 18.8×10 9/L, neutrophil count was 8.3×10 9/L, C-reactive protein was 88.8 mg/L, procalcitonin was 35.9 μg/L, alanine aminotransferase (ALT) was 150 U/L, and aspartate aminotransferase (AST) was 121 U/L. Infectious fever and diarrhea were diagnosed. After 3 days of treatment with ceftriaxone, the diarrhea was improved, but there was still fever. Ceftriaxone was replaced by meropenem (20 mg/kg by intravenous infusion, once per 8 hours). Three days later, the infant′s ALT, AST and white blood cell count returned to normal, but she still experienced recurrent fever (up to 39.0 ℃) and mental fatigue, which was considered to be intracranial infection. The dose of meropenem was doubled (40 mg/kg by intravenous infusion, once per 8 hours), and 3 days later, the infant′s body temperature was normal, but mild yellowish skin occurred, with ALT 1 442 U/L, AST 2 868 U/L, direct bilirubin 20.0 μmol/L, and total bile acid (TBA) 90 μmol/L. Acute liver injury caused by meropenem was considered, the drug was replaced by ceftazidime, and liver-protective treatments such as glutathione and ademetionine were given. After 9 days, the infant′s ALT was 140 U/L, AST was 116 U/L, TBA was 46.3 μmol/L, and yellowish skin disappeared. Two weeks later, her liver function indexes basically returned to normal.
