Retrospective analysis of adverse reactions of nervous system caused by antibiotics
XU Bingfa1 QIN Kan1 SUN Jing1 REN Tingting2 SUN Wanlu3 TAI Hui4 WEN Gang5
1.Department of Pharmacy, the Third Affiliated Hospital of Anhui Medical University, Anhui Province, Hefei 230061, China;
2.Department of Pharmacy, Lujiang County People′s Hospital, Anhui Province, Lujiang 231500, China;
3.Department of Pharmacy, Funan County People′s Hospital, Anhui Province, Funan 236300, China;
4.Department of Pharmacy, Biyang County People′s Hospital, He′nan Province, Biyang 463700, China;
5.Department of Gastroenterology, the Third Affiliated Hospital of Anhui Medical University, Anhui Province, Hefei 230061, China
Abstract：Objective To investigate the occurrence and risk factors of nervous system adverse reaction induced by antibiotics. Methods The adverse drug reaction (ADR) reported in the Third Affiliated Hospital of Anhui Medical University from January 2003 to June 2019 were analyzed, including 103 cases of neurological adverse reactions related to antibiotics. The gender, age, time of occurrence of ADR, dosage, dosage form, mode of administration and combination of drugs were analyzed. Results The rate of over 70 years old was the highest in 103 patients (33.0%). The most common antibiotics causing adverse reactions of nervous system were fluoroquinolones (49.1%), cephalosporins (14.2%), macrolides (9.4%), triazoles (8.5%), the incidence of Clindamycin, Voriconazole and Moxifloxacin was the highest among the single cultivars. ADR of nervous system mainly occurred within one day after administration (87.7%). Conclusion The ADR of nervous system caused by antibiotics should be paid enough attention. Careful selection of antibiotics, individualized administration and intensive drug monitoring are essential to reduce the adverse reactions of nervous system.
[1] 李俊.临床药理学[M].北京：人民卫生出版社，2008.
[2] Zareifopoulos N，Panayiotakopoulos G. Neuropsychiatric Effects of Antimicrobial Agents [J]. Clin Drug Investig，2017， 37（5）：423-437.
[3] CFDA.关注氟喹诺酮类药品的严重不良反应.[EB/OL]药品不良反应信息通报（第58期）.[2013-11-21].http：//samr.cfda.gov.cn/WS01/CL1989/94324.html.
[4] CFDA.总局关于修订全身用氟喹诺酮类药品说明书的公告（2017年第79号）[EB/OL].[2017-07-05].http：//samr.cfda.gov.cn/WS01/CL1706/174528.html.
[5] File TM Jr，Tillotson GS. Gemifloxacin：a new，potent fluoroquinolone for the therapy of lower respiratory tract infections [J]. Expert Rev Anti Infect Ther，2004，2（6）：831-843.
[6] Leone R，Venegoni M，Motola D，et al. Adverse drug reactions related to the use of fluoroquinolone antimicrobials：an analysis of spontaneous reports and fluoroquinolone consumption data from three Italian regions [J]. Drug Saf，2003（26）：109-120.
[7] Rageh AH，Atia NN，Abdel-Rahman HM. Application of salting-out thin layer chromatography in computational prediction of minimum inhibitory concentration and blood-brain barrier penetration of some selected fluoroquinolones [J]. J Pharm Biomed Anal，2018，159：363-373.
[8] Tomé AM，Filipe A. Quinolones：review of psychiatric and neurological adverse reactions [J]. Drug Saf， 2011，34（6）：465-488.
[9] Vardakas KZ，Kalimeris GD，Triarides NA，et al. An update on adverse drug reactions related to β-lactam antibiotics [J]. Expert Opin Drug Saf，2018，17（5）：499-508.
[10] 李冬梅，杨静，丁琼. β-内酰胺类抗菌药物致血液透析患者癫痫发作11例[J].医药导报2019，38（8）：1094-1096.
[11] Li HT，Lee CH，Wu T，et al. Clinical，Electroencephalographic Features and Prognostic Factors of Cefepime-Induced Neurotoxicity：A Retrospective Study [J]. Neurocrit Care 2019，31（2）：329-337.
[12] Appa AA，Jain R，Rakita RM，et al. Characterizing Cefepime Neurotoxicity：A Systematic Review [J]. Open Forum Infect Dis，2017，4（4）：ofx170.
[13] 刘茂昌，葛苗苗，陈渝军，等.美罗培南与亚胺培南/西司他汀治疗重症感染疗效与安全性的Meta分析[J].中国抗生素杂志，2014，39（10）：785-790.
[14] 陈惠娟，郑刚，刘斌.头孢孟多酯钠所致不良反应近况文献概述[J].中国药物滥用防治杂志，2015，21（5）：292.
[15] 王婧.甲硝唑联合克林霉素在阴道炎患者中的临床应用及安全性研究[J].三峡大学学报：自然科学版，2017（S1）：118-119.
[16] 范铭，彭雯艳，沈春英，等.克林霉素致不良反应文献分析[J].医药导报，2010，29（7）：963-965.
[17] CFDA.阿米卡星注射液、林可霉素注射液、环丙沙星注射液、克林霉素注射液的不良反应[EB/OL].药品不良反应信息通报（第5期）.[2003-12-23]. http：//samr.cfda.gov.cn/WS01/CL1989/11277.html.
[18] CFDA.警惕克林霉素注射剂的严重不良反应、关注藻酸双酯钠注射剂的严重不良反应[EB/OL].药品不良反应信息通报（第20期）.[2009-03-24]. http：//samr.cfda.gov.cn/WS01/CL1989/36756.html.
[19] Geist MJ，Egerer G，Burhenne J，et al. Steady-state pharmacokinetics and metabolism of voriconazole in patients [J]. J Antimicrob Chemother，2013，68（11）：2592-2599.
[20] Haiping L，Ziqiang J，Qina Z，et al. Adverse reactions of fluoroquinolones to central nervous system and rational drug use in nursing care [J]. Pak J Pharm Sci，2019，32（1（Special））：427-432.
2020, Vol. 17 
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