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Serious Neurological Adverse Events of Ceftriaxone

We described ceftriaxone-induced CNS adverse events through the largest case series of Adverse Drug Reactions (ADRs) reports, from 1995 to 2017, using the French Pharmacovigilance Database. In total, 152 cases of serious CNS ADRs were analyzed; 112 patients were hospitalized or had a prolonged hospi...

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Autores principales: Lacroix, Clémence, Bera-Jonville, Annie-Pierre, Montastruc, François, Velly, Lionel, Micallef, Joëlle, Guilhaumou, Romain
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8148437/
https://www.ncbi.nlm.nih.gov/pubmed/34066591
http://dx.doi.org/10.3390/antibiotics10050540
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author Lacroix, Clémence
Bera-Jonville, Annie-Pierre
Montastruc, François
Velly, Lionel
Micallef, Joëlle
Guilhaumou, Romain
author_facet Lacroix, Clémence
Bera-Jonville, Annie-Pierre
Montastruc, François
Velly, Lionel
Micallef, Joëlle
Guilhaumou, Romain
author_sort Lacroix, Clémence
collection PubMed
description We described ceftriaxone-induced CNS adverse events through the largest case series of Adverse Drug Reactions (ADRs) reports, from 1995 to 2017, using the French Pharmacovigilance Database. In total, 152 cases of serious CNS ADRs were analyzed; 112 patients were hospitalized or had a prolonged hospitalization (73.7%), 12 dead (7.9%) and 16 exhibited life-threatening ADRs (10.5%). The median age was 74.5 years, mainly women (55.3%), with a median creatinine clearance of 35 mL/min. Patients mainly exhibited convulsions, status epilepticus, myoclonia (n = 75, 49.3%), encephalopathy (n = 45, 29.6%), confused state (n = 34, 22.4%) and hallucinations (n = 16, 10.5%). The median time of onset was 4 days, and the median duration was 4.5 days. The mean daily dose was 1.7 g mainly through an intravenous route (n = 106, 69.7%), and three patients received doses above maximal dose of Summary of Product Characteristics. Ceftriaxone plasma concentrations were recorded for 19 patients (12.5%), and 8 were above the toxicity threshold. Electroencephalograms (EEG) performed for 32.9% of the patients (n = 50) were abnormal for 74% (n = 37). We described the world’s biggest case series of ceftriaxone-induced serious CNS ADRs. Explorations (plasma concentrations, EEG) are contributive to confirm the ceftriaxone toxicity-induced. Clinicians may be cautious with the use of ceftriaxone, especially in the older age or renal impairment population.
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spelling pubmed-81484372021-05-26 Serious Neurological Adverse Events of Ceftriaxone Lacroix, Clémence Bera-Jonville, Annie-Pierre Montastruc, François Velly, Lionel Micallef, Joëlle Guilhaumou, Romain Antibiotics (Basel) Article We described ceftriaxone-induced CNS adverse events through the largest case series of Adverse Drug Reactions (ADRs) reports, from 1995 to 2017, using the French Pharmacovigilance Database. In total, 152 cases of serious CNS ADRs were analyzed; 112 patients were hospitalized or had a prolonged hospitalization (73.7%), 12 dead (7.9%) and 16 exhibited life-threatening ADRs (10.5%). The median age was 74.5 years, mainly women (55.3%), with a median creatinine clearance of 35 mL/min. Patients mainly exhibited convulsions, status epilepticus, myoclonia (n = 75, 49.3%), encephalopathy (n = 45, 29.6%), confused state (n = 34, 22.4%) and hallucinations (n = 16, 10.5%). The median time of onset was 4 days, and the median duration was 4.5 days. The mean daily dose was 1.7 g mainly through an intravenous route (n = 106, 69.7%), and three patients received doses above maximal dose of Summary of Product Characteristics. Ceftriaxone plasma concentrations were recorded for 19 patients (12.5%), and 8 were above the toxicity threshold. Electroencephalograms (EEG) performed for 32.9% of the patients (n = 50) were abnormal for 74% (n = 37). We described the world’s biggest case series of ceftriaxone-induced serious CNS ADRs. Explorations (plasma concentrations, EEG) are contributive to confirm the ceftriaxone toxicity-induced. Clinicians may be cautious with the use of ceftriaxone, especially in the older age or renal impairment population. MDPI 2021-05-06 /pmc/articles/PMC8148437/ /pubmed/34066591 http://dx.doi.org/10.3390/antibiotics10050540 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lacroix, Clémence
Bera-Jonville, Annie-Pierre
Montastruc, François
Velly, Lionel
Micallef, Joëlle
Guilhaumou, Romain
Serious Neurological Adverse Events of Ceftriaxone
title Serious Neurological Adverse Events of Ceftriaxone
title_full Serious Neurological Adverse Events of Ceftriaxone
title_fullStr Serious Neurological Adverse Events of Ceftriaxone
title_full_unstemmed Serious Neurological Adverse Events of Ceftriaxone
title_short Serious Neurological Adverse Events of Ceftriaxone
title_sort serious neurological adverse events of ceftriaxone
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8148437/
https://www.ncbi.nlm.nih.gov/pubmed/34066591
http://dx.doi.org/10.3390/antibiotics10050540
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