厄他培南致中枢神经系统不良反应的文献分析

中国药物警戒 ›› 2015, Vol. 12 ›› Issue (11): 674-678.

厄他培南致中枢神经系统不良反应的文献分析

董悦^{1, 2}, 胡欣^2*

1北京大学医学部药事管理与临床药学系,北京 100191；
2北京医院药学部,北京 1007301

收稿日期:2016-02-02 修回日期:2016-02-02 出版日期:2015-11-08 发布日期:2016-02-02
通讯作者: 胡欣,男,主任药师,医院药学。E-mail：huxinbjyy@126.com
作者简介:董悦,女,在读硕士,临床药学。

Literature Analysis of Adverse Drug Reaction on Central Nervous System Induced by Ertapenem

DONG Yue^{1, 2}, HU Xin^{2, *}

1Department of Administration and Clinical Pharmacy, Peking University School of Pharmaceutical Sciences, Beijing 100191, China;
2Department of Pharmacy, Beijing Hospital, Beijing 100730, China

Received:2016-02-02 Revised:2016-02-02 Online:2015-11-08 Published:2016-02-02

摘要/Abstract

摘要： 目的对厄他培南致中枢神经系统不良反应的发生规律进行总结,为医务人员安全合理用药提供参考。方法以ertapenem、adverse drug reaction、delirium、encephalopathy、antibiotic neurotoxicity、seizure、central nervous system toxicity、epileptogenic、厄他培南、不良反应、中枢神经系统毒性、谵妄、癫痫为关键词,检索PubMed、EMBASE、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）、中文科技期刊数据库（VIP）、万方数据资源系统(WANFANG DA),收集2001~2015年关于厄他培南致中枢神经系统不良反应的临床研究和个案报道,并对检索到的文献进行综述。结果本研究纳入8篇英文文献,2篇中文文献,纳入患者20例,男性13例（65.00%）,女性7例（35.00%）,年龄分布在40~89岁;不良反应发生在用药5~7天（65.00%）,临床主要表现为精神异常（55.00%）及癫痫样抽搐（40.00%）;20例不良反应患者中,11例（55.00%）停药后症状好转,6例（30.00%）停药并采用抗癫痫药物治疗后患者症状好转, 3例（15.00%）患者死于非药物原因。结论厄他培南可导致严重中枢神经系统不良反应,当患者合并有中枢神经系统不良反应高危因素时,医务人员应避免使用厄他培南或密切监测患者的不良反应,必要时予以停药与对症治疗。

关键词: 厄他培南, 中枢神经系统, 不良反应

Abstract: ObjectiveTo analyze the situation and clinical characteristics of adverse drug reaction on central nervous system induced by ertapenem in order to provide references for rational drug use. MethodsErtapenem, adverse drug reaction, delirium, encephalopathy, antibiotic neurotoxicity, seizure, central nervous system toxicity and epilepsy were selected as the search words. PubMed,EMBASE,CBM,CNKI,VIP and WANFANG database were searched from 2001~2015. The literatures and case reports of adverse drug reaction on central nervous system induced by ertapenem were collected. The data were analyzed retrospectively including characteristics of patients, drug use as well as types, onset time, clinical manifestations, treatment and prognosis to adverse drug reaction. ResultsA total of 10 clinical research papers and adverse drug reaction reports(including 8 English papers and 2 Chinese papers )were selected.20 patients were enrolled in this study. They comprised 13 men(65.00%) and 7 women(35.00%) with average age of 40~89 years. The onset time to adverse drug reaction induced by ertapenem was within 5~7 days(65.00%)The clinical manifestations in most patients were mental disorder(55.00%) and epileptic seizures(40.00%). In total of 20 patients, 11 patients (55.00%) improved after receiving the drug discountinuation, 6 patients (30.00%) improved after receiving the drug discountinuation and symptomatic treatment, 3 patients (15.00%) died of non-drug reason. ConclusionErtapenem can lead to adverse effects on central nervous system in patients with risk factors of central nervous system toxicity, and such patients should avoid to use it or followed by a careful adverse drug reaction monitoring. The application of drugs should be ceased immediately once the adverse reactions were monitored, and meanwhile the relevant symptomatic therapies should be applied.

Key words: ertapenem, central nervous system, adverse reaction

中图分类号:

R994.11

董悦, 胡欣. 厄他培南致中枢神经系统不良反应的文献分析[J]. 中国药物警戒, 2015, 12(11): 674-678.

DONG Yue, HU Xin. Literature Analysis of Adverse Drug Reaction on Central Nervous System Induced by Ertapenem[J]. Chinese Journal of Pharmacovigilance, 2015, 12(11): 674-678.

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