[Recommended dosage adaptation based on renal function is not always sufficient to avoid betalactam antibiotics side effects].
The potential neurotoxicity of betalactam antibiotics are well-known and is frequently associated with drug accumulation in patients with renal failure since these antibiotics are eliminated mostly by kidneys. The regional center of pharmacovigilance of Amiens has collected since 10 years, 20 notifications of neurotoxicity induced by betalactam antibiotics. The series included eight women and 12 men. Mean age was 65 years (26-84). The drug accumulation hypothesis was strengthened in nine cases by assays of plasma levels residual concentrations. In 17 cases, betalactam antibiotics dosage was adapted to creatinin clearance in accordance to the Summary of the Product Characteristics' (SPC) recommendations. For several drugs, no adaptation to renal function was proposed by SPC. Dosage adaptation based only on renal function as it's recommended is not always efficient to avoid neurological side effects.
Lemaire-Hurtel
Anne-Sophie
AS
Service de pharmacologie clinique, groupe hospitalier Sud, CHU d'Amiens, Inserm, ERI 12, faculté de pharmacie, 80000 Amiens, France. hurtel.anne-sophie@chu-amiens.fr
Gras-Champel
Valérie
V
Hary
Lionel
L
Masmoudi
Kamel
K
Massy
Ziad
Z
Andréjak
Michel
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D003404:Creatinine / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004827:Epilepsy / Q000139:chemically induced* / Q000453:epidemiology; D005260:Female; D005602:France / Q000453:epidemiology; D018756:GABA Antagonists / Q000009:adverse effects; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D047090:beta-Lactams / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics
D000900:Anti-Bacterial Agents; D018756:GABA Antagonists; D047090:beta-Lactams; D003404:Creatinine