A novel analytical method to assess the effect of imipenem/cilastatin on liver function laboratory indexes in Chinese underage inpatients: Probability distribution curve


Autoři: Le Zou aff001;  Fanqi Meng aff002;  Weici Wang aff001;  Qianqian Ye aff001;  Lin Hu aff001;  Taoming Li aff005;  Tao Yin aff001
Působiště autorů: Pharmacy Department, Xiangya Hospital, Central South University, Changsha, Hunan Province, China aff001;  The Seventh Affiliated Hospital, Sun Yet-sun University, Shenzhen, Guangdong Province, China aff002;  Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan Province, China aff003;  Pharmacy Department, Hubei University of Science and Technology, Xianning, Hubei Province, China aff004;  Pharmacy Department, The Fourth Hospital of Changsha, Changsha, Hunan Province, China aff005
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224352

Souhrn

Objectives

The primary objective of this study was to establish a novel method to assess the effect of imipenem/cilastatin (IMP) on liver function laboratory indexes in Chinese underage inpatients (inpatients aged <18 year-old).

Methods

A retrospective study was conducted in 188 underage inpatients who received IMP in Xiangya Hospital from January 2016 to April 2018. Demographic data and clinical information of these inpatients were collected. As there was no reference interval of minors, the occurrence of abnormal liver function was estimated by that of adults, temporarily. A new concept (mean-variance induced by drug, MVID) was introduced to analyze the characteristics of total bilirubin (TBil), direct bilirubin (DBil), alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Effect of MVID of TBil, DBil, ALT and AST in different patients (aged<1 year old and aged ≥ 1 year old) were compared by Mann-Whitney U test.

Results

Estimating by reference intervals of adults, 57.4% underage inpatients (108/188) had abnormal liver function. According to the probability distribution curve of MVID, IMP can cause the increase of AST in 24% (0.62–0.38) Chinese underage inpatients, and the increase of ALT in 20% (0.60–0.40) Chinese underage inpatients. And liver protecting drugs can decrease MVID of ALT and AST. There were not statistically significant differences in MVID of TBil, DBil, ALT and AST in different patients (aged<1 year old and aged ≥ 1 year old); P value was 0.711, 0.734, 0.067 and 0.086, respectively.

Conclusion

IMP can affect the liver function of 20–24% Chinese underage inpatients mainly by increasing the AST and ALT. IMP may induce hepatocellular injury, but not cholestasis. And liver protecting drugs can reverse the side effects caused by IMP. Age may not affect the effect of IMP on liver function.

Klíčová slova:

Adverse reactions – Distribution curves – Drug administration – Drug therapy – Inpatients – Liver function tests – Probability distribution – Soft tissue infections


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