3例超剂量使用阿莫西林-克拉维酸钾后尿液结晶的分析

Analysis of urine crystals in 3 cases of overdose of amoxicillin-clavulanate potassium

目的通过探讨尿液中阿莫西林-克拉维酸钾结晶的特征,有助于在日常检验工作中及早发现药物结晶,为临床安全用药提供参考。方法观察阿莫西林-克拉维酸钾结晶的形态特征并进行理化实验,再结合国内外相关文献,和尿液中其他形态相似的结晶进行鉴别区分。结果确认3例患者尿液中的结晶为阿莫西林-克拉维酸钾结晶。结论超剂量使用阿莫西林-克拉维酸钾患者的尿液中容易析出药物结晶。检验人员遇见类似针形结晶时,应考虑药物因素,要及时与临床医生沟通,询问用药情况,提示医生注意用药剂量,警惕尿液出现药物结晶的不良反应,防范因药物引起的肾损伤。

Objective To help inspectors to detect the crystals of the drug early in daily testing and provide a reference for clinical safety medication by exploring the characteristics of amoxicillin-clavulanate crystals in urine.Methods The morphological characteristics of amoxicillin-clavulanate crystals were observed and the physicochemical tests were carried out.Combined with relevant domestic and foreign literatures,other crystals with similar morphology in urine were identified and distinguished.Results Amoxicillin-clavulanate potassium crystals were confirmed in the urine of 3 patients.Conclusions The crystal of amoxicillin-clavulanate potassium is more likely to precipitate from the urine of patients with overdose of amoxicillin-clavulanate potassium.When similar needle-shaped crystals are found,the inspector should consider the adverse reactions of amoxicillin-clavulanate potassium,communicate with the clinician in time,ask about the medication,and prompt clinicians to pay attention to the dose of medication to prevent patients from renal injuries due to excessive medication.