抗生素引起多脏器功能衰竭

Muitiple Organ Faiure Caused by Antibiotic

本文报告1例老年患者,因不明热在院外服用头孢氨苄和肌注庆大霉素引起肾功能不全和肝功能损害,入院后换用头孢唑啉钠、丁胺卡那霉素和头孢哌酮,出现黄疸,无尿和皮疹,肝肾功能进一步恶化。因高热持续不退又改用头孢三嗪,引起的白色念珠菌感染、鼻衄、呕血和黑便,最后患者死于多脏器功能衰竭(肝、肾、消化道和皮肤)。提示氨基糖甙抗生素的肾损害,头孢氨苄的肝毒性和头孢哌酮、头孢三嗪的消化道出血的副作用是严重的。本文还讨论了这些抗生素的副作用发生机理,以提醒我们重视抗生素的合理应用。

One case of multiple organ failure ccaused by an-tibiotic was reported, Before admission, the aged pa-tient with fever (unknown cause) administered oralcephalexin and infusion gentamycin, After admission,amikaim, cefasolin and cefobid were continuously giv-en when rellal dysfuntion and liven impairment werefound. Sinee then jaundice, anuria and skin rash alsooccurred and renal and liver function further deterio-rated. Ceftriaxone was also given when patient's feverwas not controled. And then, infection of Candidaalbicans, hematemesis and melena were found. Finallythis patient died of multipe organ failure (kidney, liver,gastrointestinal trat and skin). It is suggested that aminoglycosis (gentamyin andamikacin) may precipitate acute renal function failure,cephalexin is assocciated with liver impairment andCephalosporin (Cefobid and Ceftriaxoe) result ingastrointestinal bleeding attention and caution side ef-fects of these antibotics, so that they can be rationallyused.