| アブストラクト | INTRODUCTION: Among antibiotics, Central Nervous System (CNS) adverse drug reactions (ADRs) are often under-suspected and overlooked. Cephalosporins are an important cause of drug-induced CNS ADRs but the characteristics of such ADR have not been fully explored. We aimed to characterize the profile of cephalosporins serious CNS ADRs. METHOD: We performed an analysis of serious reports recorded in the French Pharmacovigilance database from 1987 to 2017. RESULTS: A total of 511 serious ADRs reports was analyzed. Patients had a mean age of 67.1years and were mainly men (52.5%), with a mean creatinine clearance of 32.9ml/min. The most involved molecules were cefepime (33.1%), ceftriaxone (29.7%), ceftazidime (19.6%), cefotaxime (9%) and cefazoline (2.9%), mostly administered intravenously (87.3%). A CNS history was observed in 25% of the reports (n=128). Patients exhibited encephalopathy (30.3%), confusional state (19.4%), convulsion (15.1%), myoclonia (9.4%), status epilepticus (9.2%), coma (6.3%) and hallucination (4.3%). The mean time of onset was 7.7days and the mean duration was 6days. Cephalosporin plasma levels were recorded for 153 patients (29.9%) and 107 were above the standards including 62 (57.9%) related to renal impairment. Electroencephalograms were performed in 38.2% (n=195) of the patients and 81% (n=158) were abnormal. CONCLUSION: This study characterizes an off-target CNS ADRs of several cephalosporins. Ceftriaxone represented a large part of our reports after cefepime and it would be relevant to warn healthcare professionals. Investigations (EEG, though plasma levels and renal function) can be precious tools for clinicians to make a prompt diagnosis and improve patients' outcomes. |
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| ジャーナル名 | Journal of the neurological sciences |
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| Pubmed追加日 | 2019/1/27 |
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| 投稿者 | Lacroix, C; Kheloufi, F; Montastruc, F; Bennis, Y; Pizzoglio, V; Micallef, J |
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| 組織名 | Centre Regional de Pharmacovigilance, Service de Pharmacologie Clinique et;Pharmacovigilance, APHM, INSERM, Inst Neurosci Syst, Aix Marseille Univ,;Marseille, France.;Centre Midi-Pyrenees de Pharmacovigilance, Pharmacoepidemiologie et;d'Informations sur le Medicament, Centre Hospitalier Universitaire, Faculte de;Medecine, Service de Pharmacologie Medicale et Clinique, Toulouse, France; Unite;clinique de Pharmacologie psychiatrique, Faculte de Medecine, Centre Hospitalier;Universitaire, Toulouse, France.;Centre Regional de Pharmacovigilance, Centre Hospitalier Universitaire;Amiens-Picardie, Amiens, France.;Centre Regional de Pharmacovigilance, Hospices Civils de Lyon, Lyon, France.;Marseille, France. Electronic address: joelle.micallef@ap-hm.fr. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/30683462/ |
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