Le infezioni in medicina · 2022
A case of ceftriaxone-induced liver injury and literature review.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Guarino Matteo, Perna Benedetta, Pastorelli Alessandra, Bertolazzi Paolo, Caio Giacomo, Maritati Martina, De Giorgio Roberto, Contini Carlo
Аннотация
BACKGROUND: Liver injury evoked by drugs spans various clinical manifestations ranging from mild biochemical abnormalities to acute liver failure. Ceftriaxone is a third-generation cephalosporin often used in clinical practice for its long half-life, high tissue penetration rate, wide spectrum and good safety profile. Ceftriaxone, as other cephalosporins have little hepatotoxicity; however, few cases of toxic hepatitis induced by this antibiotic have been reported.
CASE PRESENTATION: We describe a case of acute, drug-induced liver injury ('hepatitis') in a 77 years-old female patient treated with ceftriaxone for pneumonia. After 48 hours from antibiotic administration, clinical condition worsened with a clinical and laboratory profile compatible with an acute non cholestatic liver injury. Ceftriaxone administration was immediately stopped and the patient was treated with hydro-electrolyte replacement, high-flow oxygen, vitamin K infusion, steroids and proton-pump inhibitors with a progressive clinical improvement.
CONCLUSIONS: Even if rare, a ceftriaxone-induced hepatotoxicity (confirmed by RUCAM score), should be considered when all other possible causes have been excluded.
CASE PRESENTATION: We describe a case of acute, drug-induced liver injury ('hepatitis') in a 77 years-old female patient treated with ceftriaxone for pneumonia. After 48 hours from antibiotic administration, clinical condition worsened with a clinical and laboratory profile compatible with an acute non cholestatic liver injury. Ceftriaxone administration was immediately stopped and the patient was treated with hydro-electrolyte replacement, high-flow oxygen, vitamin K infusion, steroids and proton-pump inhibitors with a progressive clinical improvement.
CONCLUSIONS: Even if rare, a ceftriaxone-induced hepatotoxicity (confirmed by RUCAM score), should be considered when all other possible causes have been excluded.