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Acute interstitial nephritis following amoxicillin overdose

S F Schellie, T Groshong

    Missouri Medicine
    |July 16, 1999
    PubMed

    Insights

    A pediatric amoxicillin overdose caused acute kidney injury, presenting as oliguric renal failure with hematuria and crystalluria. Full recovery was achieved with conservative management, highlighting potential adverse effects of antibiotic overdose.

    Area of Science:

    • Pediatric Nephrology
    • Pharmacology
    • Toxicology

    Background:

    • B-lactam antibiotics, including amoxicillin, are frequently prescribed for pediatric infections.
    • Acute interstitial nephritis is a known, albeit rare, adverse effect associated with B-lactam antibiotics.

    Observation:

    • A 4-year-old boy presented after ingesting a significant overdose of amoxicillin (240 mg/kg).
    • The patient developed acute oliguric renal failure, characterized by decreased urine output, hematuria (blood in urine), and crystalluria (crystals in urine).

    Findings:

    • Laboratory evaluations revealed hyperkalemia (elevated potassium levels) as a complication.
    • The patient's renal function and electrolytes were monitored closely during hospitalization.
    • Conservative management led to a complete recovery of kidney function.

    Implications:

    • This case underscores the potential for serious adverse renal effects from amoxicillin overdose, even in pediatric patients.
    • It highlights the importance of considering medication toxicity in cases of acute kidney injury in children.
    • Even commonly used medications can have significant toxicity at high doses, necessitating careful management and monitoring.

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