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Acute interstitial nephritis associated with mezlocillin, nafcillin, and gentamicin treatment for Pseudomonas
Abstract:
Two patients developed acute interstitial nephritis (AIN) following treatment with mezlocillin sodium. Diagnosis was made by renal biopsy. Gallium 67 citrate scanning was abnormal in both. All patients were receiving multiple-drug therapy, but AIN has either not been described with the other drugs, or the temporal relationship between the AIN and termination of other drug therapy makes a causative relationship unlikely. All were infected with Pseudomonas aeruginosa. A role for the infecting organism or drug synergism in contributing to the renal disease cannot be excluded.
Insights
Two patients experienced acute interstitial nephritis (AIN) after mezlocillin sodium treatment. Renal biopsy confirmed AIN, and Gallium 67 citrate scans were abnormal, suggesting a link to this antibiotic.
Area of Science:
- Nephrology
- Pharmacology
- Infectious Diseases
Background:
- Acute interstitial nephritis (AIN) is a potential adverse drug reaction.
- Antibiotic-induced AIN is a recognized clinical entity.
- Mezlocillin sodium is a penicillin-class antibiotic.
Observation:
- Two patients presented with AIN following mezlocillin sodium administration.
- Renal biopsy confirmed the diagnosis of AIN in both cases.
- Abnormal Gallium 67 citrate scans were noted in both patients.
Findings:
- The temporal relationship and lack of prior reports suggest mezlocillin sodium as a likely cause of AIN.
- Patients were on multiple-drug therapy, complicating etiological determination.
- The presence of Pseudomonas aeruginosa infection and potential drug synergism were considered contributing factors.
Implications:
- This case highlights mezlocillin sodium as a potential cause of AIN.
- Further investigation into drug-induced renal injury is warranted.
- Consideration of antibiotic stewardship and patient monitoring for renal complications is crucial.