Ceftriaxone-associated Biliary Sludge in an Adult

Ceftriaxone相關之成人膽泥案例報告

王佳玲(Chia-Ling Wang)；賴淑惠(Shu-Huei Lai)；劉有增(Yeu-Jun Lau)

膽泥 ； 成人 ； Ceftriaxone ； biliary sludge ； adult

臺灣臨床藥學雜誌

20卷1期（2012 / 03 / 31）

59 - 65

英文

Ceftriaxone是常用的第三代廣效型抗生素，具有較長的半衰期（約5.8-8.7 小時）可一天給藥一次。使用ceftriaxone 治療的病人在成人及小孩皆已有膽泥的案例報告。本文探討一個80 歲的男性病人使用ceftriaxone 針劑（1g q12h）治療傷口感染，經過3 天後，膽紅素明顯增加並出現黃疸症狀。雖然有許多因子可能會導致膽泥的產生，但經評估過後，此位病人使用ceftriaxone 的時機與膽泥有較大相關性。藉由本文的探討，臨床醫師對於使用ceftriaxone 治療並且合併有高膽紅素的病人，應該更加小心，必須密切監測相關生化值。

Ceftriaxone is a commonly used third-generation cephalosporin with a wide antibacterial spectrum and a long elimination half-life to only dosing once-daily. However, biliary sludge has been reported in patients (including children and adults) who received ceftriaxone therapy. This is a case of an 80-year-old man who was treated with intravenous ceftriaxone 1 g every 12 hours for wound infection. After 3 days of therapy, total and direct bilirubin levels increased significantly, and the patient became jaundiced. Although there are many factors that may cause biliary sludge, we concluded that the case is highly related to ceftriaxone.Clinicians need to be aware of the association of ceftriaxone and hyperbilirubinemia, and monitoring of biochemical laboratory data is necessary.