Tetracycline-induced renal failure after dental treatment.
BACKGROUND
Tetracyclines are broad-spectrum antibiotics used by dental practitioners in the treatment of periodontal disease. They generally are safe in adults. However, caution is advised in patients who have pre-existing kidney disease.


METHODS
A 42-year-old woman with polycystic kidney disease received a prescription for tetracycline (250 milligrams, four times daily) after undergoing tooth extractions. She developed nausea, vomiting and diarrhea within days and end-stage renal disease within two weeks of taking the antibiotic. Hemodialysis was required to stabilize the patient's condition. Use of the Naranjo nomogram demonstrated an association between the two events.


CONCLUSIONS
This case illustrates the importance of obtaining a thorough medical history and understanding potential adverse drug effects before prescribing a common antibiotic.
Miller
Craig S
CS
Oral Medicine Section, Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, Ky. 40536-0297, USA. cmiller@uky.edu
McGarity
Gary J
GJ
D000328:Adult; D016301:Alveolar Bone Loss / Q000601:surgery; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D017742:Dental Care for Chronically Ill / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000139:chemically induced* / Q000628:therapy; D007690:Polycystic Kidney Diseases / Q000150:complications; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000209:etiology; D013752:Tetracycline / Q000009:adverse effects*; D014081:Tooth Extraction
D000900:Anti-Bacterial Agents; D013752:Tetracycline