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(WANFANGDA),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。
Objective To 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. Methods Ertapenem, 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. Results A 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. Conclusion Ertapenem 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.
出处
《中国药物警戒》
2015年第11期674-678,共5页
Chinese Journal of Pharmacovigilance
关键词
厄他培南
中枢神经系统
不良反应
ertapenem
central nervous system
adverse reaction