哌拉西林钠他唑巴坦钠致肝损伤

Liver injury induced by piperacillin sodium and tazobactam sodium

1例44岁女性患者因急性阑尾炎给予哌拉西林钠他唑巴坦钠4.5 g静脉滴注、1次/8 h，无其他合并用药。用药前患者ALT 27 U/L，AST 21 U/L。第3天患者腹痛明显减轻，但ALT升至159 U/L，AST升至124 U/L，考虑可能为哌拉西林钠他唑巴坦钠所致，当日停用该药，改用头孢西丁钠2 g＋0.9%氯化钠注射液100 ml静脉滴注、2次/d，并给予异甘草酸镁注射液0.1 g＋5%葡萄糖注射液250 ml静脉滴注、1次/d。停用哌拉西林钠他唑巴坦钠第5天，患者ALT 65 U/L，AST 32 U/L；第42 天，ALT 31 U/L，AST 23 U/L。

A 44-year-old female patient with acute appendicitis received an IV infusion of piperacillin sodium and tazobactam sodium 4.5 g once every 8 hours. No other combined drugs were given at the same time. The patient′s alanine aminotransferase （ALT） and aspartate aminotransferase （AST） levels were 27 U/L and 21 U/L, respectively before treatment. Three days later, the patient′s abdominal pain was alleviated, but her ALT and AST levels increased to 159 U/L and 124 U/L, respectively. It was considered that the liver injury was induced by piperacillin sodium and tazobactam sodium. The drug was stopped at that day and IV infusion of cefoxitin sodium 2 g＋0.9% sodium chloride 100 ml twice daily and magnesium isoglycyrrhizinate injection 0.1 g＋5% glucose injection 250 ml once daily were given. On the 5th day of piperacillin sodium and tazobactam sodium were withdrawn, the patient′s ALT and AST levels were 65 U/L and 32 U/L and on the 42th day, 31 U/L and AST 23 U/L, respectively.