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

Abstract

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

CLC Number:

R994.11

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.

References

[1] Lee K H, Ueng Y F, Wu C W, et al. The recommended dose ofertapenem poses a potential risk for central nervous system toxicity inhaemodialysis patients - case reports and literature reviews[J]. J Clin Pharm Ther,2015,40(2):240-244.
[2] So taric N, Beovic B, Maticic M. Ertapenem-associated seizures in a patientwithout prior CNS disorder or severe renal dysfunction[J]. Int J Clin Pharmacol Ther,2014,52(3):255-258.
[3] Duquaine S, Kitchell E, Tate T, et al. Central nervous system toxicity associated with ertapenemuse[J]. Ann Pharmacother,2011,45(1):e6.
[4] Seto A H, Song J C, Guest S S. Ertapenem-associated seizures in a peritonealdialysis patient[J]. Ann Pharmacother, 2005,39(2):352-356.
[5] Ong C, Chua A C, Tambyah P A, et al. Seizures associated with ertapenem[J]. Int J AntimicrobAgents, 2008,31(3):290.
[6] Shea Y F, Mok M Y, Cheng K C, et al. Delayed recovery from ertapeneminduced encephalopathy:case-report and a possible mecha- nism[J]. Int J Clin Pharm,2013,5(4):535-537.
[7] Oo Y, Packham D, Yau W, et al. Ertapenem-associated psychosis andencephalopathy[J]. Intern Med J,2014,44(8):817-819.
[8] Apodaca K, Baker J, Bin-Bilal H, et al. Ertapenem-InducedDelirium: A Case Report and Literature Review[J].Psychosomatics,2015,56(5):561-566.
[9] Fica A E, Abusada N J. Seizures associated with ertapenem use in patients with CNS disorders and renal insufficiency[J]. Scand J Infect Dis,2008,40(11-12):983-985.
[10] 才旭,沈维. 厄他培南致谵妄症状3例并文献复习[J].中国新药与临志,2014,33(2):154-156.
[11] 杨辉,张 ,邵宏. 慢性肾功能不全患者使用厄他培南致神经系统不良反应的药学监护及文献分析[J].中国新药杂志,2015,24(8):958-960.
[12] 韩亚荣,周红丽,蒋数一,等. 慢性肾衰竭并发抗生素脑病诊治分析[J]. 中国全科医学,2012,15(5B):1625-1626.
[13] 郑飞跃,吴燕,饶跃峰,等. 诺氏评估量表在药物不良反应评价中的作用及实例分析[J]. 中国药学杂志,2012,47(8):650-652.
[14] Tomera K M, Burdmann E A, Pamo Reyna O G, et al. Ertapenem versus ceftriaxone followed by appropriate oral therapy for treatment of complicated urinary tract infections in adults: results of a prospective, randomized, double-blind multicenter study[J]. Antimicrob Agents Chemother,2002,46(9):2895-2900.
[15] Klugman K P, Dagan R. Randomized comparison of meropenem with cefotaxime for treatment of bacterial meningitis. Meropenem Meningitis Study Group[J]. Antimicrob Agents Chemother,1995,39(5):1140-1146.
[16] Grill M F, MagantiR K.Neurotoxic effects associated with antibiotic use: management considerations[J]. Br J Clin Pharmacol,2011,
72(3):381-393.
[17] Chow K M, Hui a C, SzetoC C.Neurotoxicity induced by beta-
lactam antibiotics: from bench to bedside[J]. Eur J Clin Microbiol Infect Dis,2005,24(10):649-653.
[18] Grill M F, MagantiR. Cephalosporin-induced neurotox- icity: clinical manifestations, potential pathogenic mecha-nisms, and the role of electroencephalographic monitoring[J]. Ann Pharmacother,2008,42(12):1843-1850.
[19] Koppel B S, Hauser W A, Politis C, et al. Seizures in the critically ill: the role of imipenem[J]. Epilepsia,2002,42(12):1590-1593.
[20] Chow K M, Hui a C, Szeto C C. Neurotoxicity induced by beta-
lactam antibiotics: from bench to bedside[J]. Eur J Clin Microbiol Infect Dis ,2005,24(10):649-653.
[21] Grill M F, MagantiR. Cephalosporin-induced neurotox- icity: clinical manifestations, potential pathogenic mecha-nisms, and the role of electroencephalographic monitoring[J]. Ann Pharmacother,
2008,42(12):1843-1850.
[22] Snavely S R, Hodges G R. The neurotoxicity of antibacterial agents[J]. Ann Intern Med,1984,101(1):92-104.
[23] Liu X, Cheng M H, Shi C G, et al. Variability of glomerular filtration rate estimation equations in elderly Chinese patients with chronic kidney disease[J]. Clin Interv Aging,2012,7：409-415.