疑似Ceftriaxone引起的神經性不良反應之案例報告

Suspect Ceftriaxone-Induced Neurological Adverse Effects: Case Report

劉慧萍(Hui-Ping Liu) ； 林梅芳(Mei-Fang Lin)

《臺灣臨床藥學雜誌》 22卷3期 (2014/09) Pp. 159-165

https://doi.org/10.6168/FJCP.2014.2203.04

摘要

Ceftriaxone是第三代頭孢菌素，由於治療抗菌範圍較廣，半衰期長，且容易滲透到腦脊液，因此常用在嚴重的革蘭氏陰性菌感染。頭孢菌素引起的神經性不良反應可包含各種臨床表現，例如腦病或精神狀態的改變、肌陣攣及癲癇發作。本案例敘述74歲女性因使用ceftriaxone 10天而產生腦病變及癲癇發作的案例，在停藥6天後意識狀態好轉，癲癇發作控制穩定。依據文獻查證，高度懷疑是ceftriaxone引起的神經性不良反應。藉此案例希望可提醒醫療人員開立及使用ceftriaxone時，應留意病人用藥後不尋常行為之癥兆，方能減少不良反應所造成之傷害。

關鍵字

腦病變 ； 癲癇 ； 神經性不良反應

並列摘要

Ceftriaxone is a third-generation cephalosporin commonly used in serious gram-negative infections, due to broad spectrum against bacteria, long half-life, and easy to penetrate into the cerebrospinal fluid. Neurological adverse effects resulted from cephalosporins include wide ranges of clinical manifestations, such as a change in mental status or encephalopathy, and seizures. This case is a 74-year-old woman, which 10 days use of ceftriaxone with induced encephalopathy and seizures, state of consciousness was recovered and seizures were under control 6 days after discontinuation of ceftriaxone. According to the literature, the neurological adverse reactions caused by ceftriaxone were highly suspected. This case reminds medical professionals to be aware of unusual behaviors followed by ceftriaxone use, in order to reduce the possible damage caused by adverse reactions.

並列關鍵字

Ceftriaxone ； Encephalopathy ； Seizure ； Neurological Adverse Effects