The effect of metronidazole on TPN-associated liver dysfunction in neonates.
The effect of metronidazole (MNZ) on hepatic dysfunction associated with total parenteral nutrition (TPN) in neonates was investigated. Neonates receiving TPN for more than 2 weeks were divided into three groups. In group 1, TPN was given alone, in group 2, 25 mg/kg/d of MNZ was administered intravenously for the first 2 weeks of TPN, and in group 3, 50 mg/kg/d of MNZ was given for the first 3 weeks of TPN. Several parameters of liver function tests (LFTs) during the first 4 weeks of TPN were compared among these three groups. There was no significant difference of these parameters between group 1 and group 2. Although there was no significant difference of alkaline phosphatase, gamma-glutamyl transpeptidase, direct bilirubin, and total bile acid between groups 1 and 3, transaminase (glutamic oxaloacetic, glutamic pyruvic) of group 3 remained significantly lower than those of group 1. In conclusion, the administration of MNZ 50 mg/kg/d for 3 weeks, at least, prevented the elevation of transaminase during TPN in neonates, suggesting the possible involvement of intestinal anaerobic flora in the pathogenesis of TPN-associated liver dysfunction.
Kubota
A
A
Department of Pediatric Surgery, Osaka University Medical School, Japan.
Okada
A
A
Imura
K
K
Kawahara
H
H
Nezu
R
R
Kamata
S
S
Takagi
Y
Y
D002780:Cholestasis, Intrahepatic / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D008099:Liver / Q000187:drug effects / Q000378:metabolism; D008795:Metronidazole / Q000494:pharmacology / Q000627:therapeutic use*; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D000637:Transaminases / Q000378:metabolism
D008795:Metronidazole; D000637:Transaminases