Analysis of risk factors for hepatic dysfunction in elderly patients after intravenous infusion of cefoperazone and sulbactam sodium

Abstract

Abstract: Objective To investigate the risk factors of liver dysfunction in elderly patients with intravenous infusion of cefoperazone sulbactam sodium. Methods A total of 274 elderly patients who received intravenous infusion of cefoperazone sulbactam sodium for anti-infective treatment in the Hefei Second People′s Hospital from January 2021 to July 2023 were retrospectively included in this study. The occurrence of abnormal liver function during medication was observed, and the influencing factors of abnormal liver function were analyzed. Results The incidence of abnormal liver function after intravenous infusion of cefoperazone sulbactam sodium in elderly patients was 8.76% (24/274). The results of univariate analysis showed that there were no statistically significant differences in gender, body mass index (BMI), smoking, hypertension, coronary heart disease, cerebral infarction, underlying diseases, albumin (Alb) level, daily medication dose, combined medication, and blood urea nitrogen (BUN) level between the two groups (P>0.05). The age [(76.7±4.0) years vs. (72.2±3.8) years], drinking history [62.50% (15/24) vs. 38.00% (95/250)], proportion of combined diabetes [75.00% (18/24) vs. 50.40% (126/250)], total bilirubin (TBil) [(13.46±2.69) μmol/L vs. (10.47±2.08) μmol/L], prothrombin time (PT) [(15.52±1.03) s vs. (14.23±0.47) s], and the proportion of medication time ≥5 days [58.33%(14/24)vs. 28.40%(71/250)] in the abnormal liver function group were higher than those in the normal liver function group (P<0.05). Multivariate Logistic regression analysis showed that age (OR=3.601, 95%CI: 1.491~8.699), PT (OR=3.107, 95%CI: 1.543~6.254), medication time (OR=4.045, 95%CI: 2.085~7.845) and TBil (OR=6.039, 95%CI: 1.702~21.421) were risk factors for abnormal liver function (P<0.05). Conclusion Age, TBil, PT levels and medication time are risk factors for abnormal liver function after intravenous infusion of cefoperazone sulbactam sodium in the elderly. Therefore, we should strengthen the monitoring of liver function in elderly patients with the above risk factors during medication, and take immediate intervention measures once abnormal results occur.

Key words: Intravenous infusion of cefoperazone sulbactam sodium, Elderly patients, Abnormal liver function, Influencing factors

LIU Juan-juan, HONG Yuan-yuan, WANG Feng-ling, YU Xue-jiang, MENG Xiang-yun. Analysis of risk factors for hepatic dysfunction in elderly patients after intravenous infusion of cefoperazone and sulbactam sodium[J]. Chinese Hepatolgy, 2025, 30(11): 1557-1560.

References

[1] Ye L, Cheng L, Kong L, et al. Pharmacokinetic and pharmacodynamic analysis of cefoperazone/sulbactam for the treatment of pediatric sepsis by Monte Carlo simulation[J]. Anal Methods, 2022,14(11):1148-1154.
[2] Lv Q, Deng Y, Zhu X, et al. Effectiveness of cefoperazone-sulbactam alone and combined with tigecycline in the treatment of multi-drug resistant acinetobacter baumannii pulmonary infection[J]. J Coll Physicians Surg Pak, 2020,30(3):332-334.
[3] 冯若梅, 李超. 哌拉西林他唑巴坦钠与头孢哌酮舒巴坦钠对老年慢阻肺合并感染患者的临床疗效评价[J]. 贵州医药, 2022,46(9):1420-1421.
[4] Lan S H, Chao C M, Chang S P, et al. Clinical efficacy and safety of cefoperazone-sulbactam in treatment of intra-abdominal infections: a systematic review and meta-analysis[J]. Surg Infect (Larchmt), 2021,22(8):763-770.
[5] Mu Y, Li J J, Wu X, et al. Cefoperazone-sulbactam and ornidazole for gardnerella vaginalis bloodstream infection after cesarean section: a case report[J]. World J Clin Cases, 2022,10(26):9323-9331.
[6] Park J H, Hong S, Jun D W, et al. Prevalence and clinical characteristics of antibiotics associated drug induced liver injury[J]. Ann Transl Med, 2021,9(8):642.
[7] 王宏强, 李佳, 邓紫薇, 等. 头孢哌酮舒巴坦致急性药物性肝损伤1例[J]. 中南药学, 2018,16(11):1663-1664.
[8] 中华医学会消化病学分会肝胆疾病协作组. 急性药物性肝损伤诊治建议(草案)[J]. 中华消化杂志, 2007,27(11):765-767.
[9] 姚苏宁, 严小惠, 周菊芝, 等. 63例院内药物性肝损害的临床分析与经济学评价[J]. 中国药房, 2010,21(30):2796-2798.
[10] Garcia-Cortes M, Robles-Diaz M, Stephens C, et al. Drug induced liver injury: an update[J]. Arch Toxicol, 2020,94(10):3381-3407.
[11] 张青霞, 周柳君, 李晓玲, 等. 老年人头孢哌酮舒巴坦用药错误报告分析与建议[J]. 中国药物警戒, 2023,20(5):574-578,582.
[12] Qian D, Zhang Y. Influence of xuebijing injection combined with cefoperazone sodium and sulbactam sodium in treating hepatitis B-induced liver cirrhosis complicated by spontaneous bacterial peritonitis: TNF-α, IL-18, IL-6, and hepatic function[J]. Am J Transl Res, 2021,13(4):2907-2914.
[13] 孙涛, 赵美, 赵敏杰, 等. 注射用头孢哌酮钠/舒巴坦钠对住院患者肝功能影响的回顾性调查[J]. 药物流行病学杂志, 2018,27(12):807-810.
[14] 李芸, 卫笑, 张蕾, 等. 头孢哌酮舒巴坦钠致青年男性患者凝血功能障碍伴肝功能异常[J]. 中国药物与临床, 2021,21(13):2363-2364.
[15] 王倩, 刘咪咪, 贺恺妮, 等. 陕西省2009-2019年药物性肝损伤患者的临床特征分析[J]. 临床肝胆病杂志, 2023,39(6):1358-1365.
[16] 李容容, 李盟, 苟悦,等. 113例抗肿瘤药物相关肝损伤的临床特点及危险因素分析[J]. 中国药物警戒, 2023,20(5):505-510.
[17] 叶圣莹, 秦燕. 糖尿病致肝损伤机制的研究进展[J]. 肝脏, 2023,28(6):737-739.
[18] Tomita Y, Fukaya T, Yamaura Y, et al. Implications of hepatic dysfunction in Kawasaki disease: time-related changes in aspartate aminotransferase, alanine aminotransferase, total bilirubin, and C-reactive protein levels[J]. Pediatr Investig, 2019,3(1):19-26.
[19] 朱愿超, 梁良, 沈姞, 等. 头孢哌酮钠舒巴坦钠致凝血功能异常的临床特征和相关因素分析[J]. 中国药学杂志,2022,57(9):741-746.
[20] 王钰莹, 于建海, 段京莉. 头孢哌酮舒巴坦引起凝血功能异常的影响因素分析研究[J].中国全科医学, 2020,23(S1):138-140.
[21] 栗啸阳, 郭代红, 孔祥豪, 等. 头孢哌酮钠/舒巴坦钠相关肝损伤的自动监测研究[J]. 药物流行病学杂志, 2020,29(9):606-609.