Experimental verification of factors influencing calcium salt formation based on a survey of the development of ceftriaxone-induced gallstone-related disorder.
|アブストラクト||Ceftriaxone (CTRX) forms salts with calcium (Ca) in the gall bladder and bile duct, and induces the formation of gallstones. In this study, factors of CTRX-induced gallstone formation were extracted from the results of a retrospective survey using the Japanese Adverse Drug Event Report (JADER), and the causal relationship between the factors and gallstone formation was investigated. From JADER, 136 patients who developed 'gallstone-related disorder' with CTRX as a suspected drug were extracted. The incidence of gallstone-induced adverse effects was high in patients treated with CTRX at a dose exceeding the normal daily dose and in children younger than 10 years old, suggesting that CTRX at a high level is a factor for gallstone formation. Thus, after mixing CTRX and Ca(2+) at different concentrations under different pH condition, the number of particles in the solutions was measured using a Coulter counter. As a result, the number of minute particles significantly increased at all pH values when Ca(2+) and CTRX were mixed at a concentration of 10 mEq/L or higher and 1.5 g/L or higher, respectively. At pH 6.5 or 7.0, visible crystals were detected when 25 mEq/L of Ca(2+) and 2.0 g/L of CTRX were mixed. Based on these findings, attention should be sufficiently paid to the development of 'gallstone-related disorder' in pediatric patients and in patients treated with CTRX at a dose exceeding the normal dose. Furthermore, gallstone formation and growth may be promoted when CTRX and Ca(2+) coexist at high concentrations under low pH conditions.|
|ジャーナル名||Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy|
|投稿者||Ito, Rui; Yoshida, Asami; Taguchi, Kazuaki; Enoki, Yuki; Yokoyama, Yuta; Matsumoto, Kazuaki|
|組織名||Division of Practical Pharmacy, Keio University Faculty of Pharmacy, 1-5-30;Shibakoen, Minato-ku, Tokyo, 105-8512, Japan.;Division of Pharmacodynamics, Keio University Faculty of Pharmacy, 1-5-30;Shibakoen, Minato-ku, Tokyo, 105-8512, Japan. Electronic address:;firstname.lastname@example.org.;Shibakoen, Minato-ku, Tokyo, 105-8512, Japan; Division of Pharmacodynamics, Keio;University Faculty of Pharmacy, 1-5-30 Shibakoen, Minato-ku, Tokyo, 105-8512,;Japan.|