Tomoyuki Yamada1,2, Satoru Mitsuboshi3, Kaoru Suzuki4, Masami Nishihara4, Masashi Neo4. 1. Department of Pharmacy, Osaka Medical and Pharmaceutical University Hospital, 569-8686, Takatsuki, Osaka, Japan. tomoyuki.yamada.cd@ompu.ac.jp. 2. Infection Control Center, Osaka Medical and Pharmaceutical University Hospital, 569-8686, Takatsuki, Osaka, Japan. tomoyuki.yamada.cd@ompu.ac.jp. 3. Department of Pharmacy, Kaetsu Hospital, 956-0814, Niigata-shi, Niigata, Japan. 4. Department of Pharmacy, Osaka Medical and Pharmaceutical University Hospital, 569-8686, Takatsuki, Osaka, Japan.
Abstract
BACKGROUND: The profile of ceftriaxone-induced encephalopathy is not well understood. AIM: To identify risk factors associated with ceftriaxone-induced encephalopathy. METHOD: In this observational study, anonymised patient data were retrieved from the open-access Japanese Adverse Drug Event Report database for ceftriaxone users aged 20 years or higher. RESULTS: Data of 256,788 individuals and 12,160 cases of encephalopathy were extracted, and 2,939 ceftriaxone users, of whom 193 had encephalopathy, were identified. A disproportionate prevalence of encephalopathy was observed among the ceftriaxone users (reported odds ratio = 1.42; 95% confidence interval [CI] = 1.23-1.65; p < 0.001). Multivariate logistic regression analysis of 2,057 ceftriaxone users showed encephalopathy was associated with female sex (odds ratio [OR] = 1.52; 95% CI, 1.05-2.19; p = 0.027), chronic kidney disease (OR = 2.32; 95% CI, 1.47-3.67; p < 0.001), a ceftriaxone dosage of > 2 g/day (OR = 2.66; 95% CI, 1.66-4.26; p < 0.001), and a treatment duration of > 14 days (OR = 1.94; 95% CI, 1.21-3.11; p = 0.006). CONCLUSION: Patients with chronic kidney disease, receiving ceftriaxone at a dosage of > 2 g/day, being treated for over 14 days, and/or females may be at an increased risk of ceftriaxone-induced encephalopathy.
BACKGROUND: The profile of ceftriaxone-induced encephalopathy is not well understood. AIM: To identify risk factors associated with ceftriaxone-induced encephalopathy. METHOD: In this observational study, anonymised patient data were retrieved from the open-access Japanese Adverse Drug Event Report database for ceftriaxone users aged 20 years or higher. RESULTS: Data of 256,788 individuals and 12,160 cases of encephalopathy were extracted, and 2,939 ceftriaxone users, of whom 193 had encephalopathy, were identified. A disproportionate prevalence of encephalopathy was observed among the ceftriaxone users (reported odds ratio = 1.42; 95% confidence interval [CI] = 1.23-1.65; p < 0.001). Multivariate logistic regression analysis of 2,057 ceftriaxone users showed encephalopathy was associated with female sex (odds ratio [OR] = 1.52; 95% CI, 1.05-2.19; p = 0.027), chronic kidney disease (OR = 2.32; 95% CI, 1.47-3.67; p < 0.001), a ceftriaxone dosage of > 2 g/day (OR = 2.66; 95% CI, 1.66-4.26; p < 0.001), and a treatment duration of > 14 days (OR = 1.94; 95% CI, 1.21-3.11; p = 0.006). CONCLUSION: Patients with chronic kidney disease, receiving ceftriaxone at a dosage of > 2 g/day, being treated for over 14 days, and/or females may be at an increased risk of ceftriaxone-induced encephalopathy.
Authors: Tarun D Singh; John C O'Horo; Courtney N Day; Jay Mandrekar; Alejandro A Rabinstein Journal: Neurocrit Care Date: 2020-12 Impact factor: 3.210