1例苯唑西林致儿童药物性肝损伤病例分析并文献复习

Case Analysis and Literature Review of a Case of Drug-Induced Liver Injury by Oxacillin in a Child

目的:为防治苯唑西林导致的儿童药物性肝损伤(DILI)提供参考。方法:分析某院1例6个月女童因先天性心脏病术后应用注射用苯唑西林钠导致DILI的案例,并复习国内外相关文献。结果:笔者检索到国内外苯唑西林致儿童DILI相关报道共9例,结合本例患儿分析发现,10例患儿在使用苯唑西林治疗后均出现不同程度的肝功能损伤,停药后肝功能逐渐恢复;患儿肝功能损伤可能与苯唑西林导致直接肝损伤有关。结论:儿童静脉滴注苯唑西林应按照药品说明书或指南推荐剂量并关注肝功能变化情况,发生DILI时需及时停药、评估,必要时给予对症处理。

Objective:To provide reference for drug-induced liver injury(DILI)by oxacillin.Methods:A case of a 6-month-old girl with DILI due to postoperative application of oxacillin injection for congenital heart disease in a hospital was analyzed,and relevant domestic and international literature was reviewed.Results:A total of 9 cases of related domestic and foreign literature were retrieved.Combined with the analysis of this case,it was found that 10 cases of children with different degrees of liver function injury after treatment with oxacillin,and liver function recovered after drug withdrawal.The liver function injury of children might be related to direct liver injury induced by oxacillin.Conclusion:Intravenous oxacillin in children should be administered at the dose recommended in the drug instructions or guidelines and with attention to changes in liver function,with prompt drug withdrawal,evaluation,and symptomatic management if necessary in the event of DILI.