Chorea-like symptoms and high blood concentration of ceftriaxone in a patient undergoing hemodialysis: A case report

Yokoyama, Yoshiaki; Hosokawa, Naoto; Kudo, Toshiyuki; Goda, Hitomi; K, Ito; Suzuki, Michitaka; Funakoshi, Ryohkan

doi:10.1016/j.jiac.2019.10.005

Cited by 7 publications

(7 citation statements)

References 13 publications

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“…We did a literature review on PubMed in April 2023 without a time limit and identified 15 case reports,4 6–9 11–13 15–18 20 21 26 7 small case series2 3 5 10 14 19 27 and 2 pharmacovigilance database analysis22 28 discussing serious neurological effects of ceftriaxone in humans.…”

Section: Discussionmentioning

confidence: 99%

“…Ceftriaxone-related adverse neurological effects are uncommon to very rare and mostly mild (dizziness, headache, ataxia, paresthesia) 1. However, multiple case reports2–21 and a case series from a French pharmacovigilance database22 have been published on more severe reactions, notably encephalopathy, trouble of consciousness and choreoathetosis. With ceftriaxone being one of the most commonly used parenteral antibiotics worldwide23, there is a possibility that many more cases of these severe adverse reactions are not readily recognised or may be confused with common delirium.…”

Section: Introductionmentioning

confidence: 99%

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Ceftriaxone-induced encephalopathy in a patient with a normal renal function

Zarauskas,

Rodrigues,

Alvarez

2024

BMJ Case Rep

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Ceftriaxone-induced encephalopathy is an exceptionally rare adverse effect of this commonly used cephalosporin and is generally observed in patients undergoing haemodialysis or suffering from severe renal failure. We present a case of a fit woman in her mid-80s with a normal renal function who developed severe fluctuating neurological symptoms (aphasia, loss of contact, chorea-like tongue movements) while being treated with ceftriaxone for a urinary tract infection with bacteraemia. The symptoms began on day 4 of treatment and an adverse drug reaction was suspected on day 7, after exhaustive investigations failed to reveal another cause. A complete recovery was observed 3 days after discontinuing ceftriaxone. Our case highlights the need to consider the diagnosis of ceftriaxone encephalopathy, even if the traditional risk factors are lacking. In this article, we also provide a brief overview of the pathophysiology as well as a literature review concerning the subject.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ceftriaxone-induced encephalopathy in a patient with a normal renal function

Zarauskas,

Rodrigues,

Alvarez

2024

BMJ Case Rep

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“…There are also scattered reports of AAE caused by CTRX, and according to an adverse drug reaction database study in France, the serious CNS adverse effects caused by CTRX and CFPM were reported to be similar [ 12 ]. AAE with CTRX has been reported more frequently in the elderly and patients with chronic kidney disease and is more likely to occur when high doses are given and blood and cerebrospinal fluid (CSF) concentrations are high [ 13 , 14 , 15 ].…”

Section: Tdm Of Ceftriaxonementioning

confidence: 99%

Importance and Reality of TDM for Antibiotics Not Covered by Insurance in Japan

Ebihara

Hamada

Kato

et al. 2022

IJERPH

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Under the Japanese health insurance system, medicines undergoing therapeutic drug monitoring (TDM) can be billed for medical fees if they meet the specified requirements. In Japan, TDM of vancomycin, teicoplanin, aminoglycosides, and voriconazole, which are used for the treatment of infectious diseases, is common practice. This means the levels of antibiotics are measured in-house using chromatography or other methods. In some facilities, the blood and/or tissue concentrations of other non-TDM drugs are measured by HPLC and are applied to treatment, which is necessary for personalized medicine. This review describes personalized medicine based on the use of chromatography as a result of the current situation in Japan.

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“…There are also scattered reports of AAE caused by CTRX, and according to an adverse drug reaction database study in France, serious CNS adverse effects caused by CTRX and CFPM were reported to be similar [11]. AAE with CTRX has been reported more frequently in the elderly and patients with chronic kidney disease and is more likely to occur when high doses are given and blood and cerebrospinal fluid (CSF) concentrations are high [12][13][14].…”

Section: Characteristics Of Ceftriaxone and Significance Of Tdmmentioning

confidence: 99%

Potential Clinical Benefits of TDM of Antimicrobials in Japan

Ebihara¹,

Hamada²,

Maruyama³

et al. 2022

Preprint

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Under the Japanese health insurance system, medicines undergoing therapeutic drug monitoring (TDM) can be billed for medical fees if they meet the specified requirements. In Japan, TDM of vancomycin, teicoplanin, aminoglycosides, and voriconazole, which are used for the treatment of infectious diseases, is common practice. This means the levels of antimicrobial agents are measured in-house using chromatography. This review describes personalized medicine based on the use of chromatography as a result of the current situation in Japan.

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Chorea-like symptoms and high blood concentration of ceftriaxone in a patient undergoing hemodialysis: A case report

Cited by 7 publications

References 13 publications

Ceftriaxone-induced encephalopathy in a patient with a normal renal function

Ceftriaxone-induced encephalopathy in a patient with a normal renal function

Importance and Reality of TDM for Antibiotics Not Covered by Insurance in Japan

Potential Clinical Benefits of TDM of Antimicrobials in Japan

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