Vol.63 No.6 November 2015
In the case of the administration of meropenem hydrate, the influence of high doses on hepatic and renal function and a retrospective study on the risk factors of hepatic and renal dysfunction
1)Department of Pharmacy, National Hospital Organizer Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, Japan
2)Department of Infectious Diseases, National Hospital Organizer Osaka National Hospital
Abstract
Meropenem (MEPM) is an antibiotic with proven tolerability by a comparative investigation of cephem, and so on. In recently years, however, as to the investigation for the safety of administration of high-dose MEPM (≥3 g/day), it has been reported that in particular hepatic dysfunction occurs much more under high dosage.
In this study, we investigated 2 items in a single center retrospective observational study: 1. The frequency of any side effect involving hepatic and renal function due to the dosage of MEPM. 2. The variation factor of the hepatic and renal function findings due to the administration of MEPM.
1. The frequency of hepatic or renal dysfunction did not differ between ≥3 g/day group (3 g/day in 156 patients, 4 g/day in 3 patients or 6 g/day in 5 patients) and <3 g/day group (1.5 g/day in 62 patients or 2 g/day in 14 patients).
2. The following are the reasons of hepatic dysfunction and renal dysfunction identified with a using logistic regression analysis: Alkaline phosphatase levels were increased with administration of vancomycin (VCM) and serum creatinine levels increased with administration of catecholamine. Although these results provide an insight into concomitant drugs-induced dysfunction rather than MEPM, it was surmised that the impact of circulatory failure or concomitant drug are related to the hepatic and renal function in those cases in which these drugs are combined.
From the above, this study indicated that the possibility of the frequency of elevated side effects is lower depending on the dosage of MEPM and there are no safety problems related with high-dose MEPM. We further considered that it is necessary in the case of a combination of VCM and catecholamine to observe the patient's course carefully.
Key word
meropenem, adverse effect, drug induced renal dysfunction, drug induced liver dysfunction
Received
March 25, 2015
Accepted
September 3, 2015
Jpn. J. Chemother. 63 (6): 553-559, 2015
