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Cefoxitin falsely elevates creatinine levels

A J Saah, T R Koch, G L Drusano

    JAMA
    |January 8, 1982
    PubMed
    Summary
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    Cefoxitin sodium interferes with creatinine tests, causing falsely elevated serum creatinine levels. This impacts kidney function assessments, especially in patients with severe renal impairment.

    Area of Science:

    • Clinical Chemistry
    • Pharmacology
    • Nephrology

    Background:

    • Cefoxitin sodium is an antibiotic commonly used in hospitals.
    • Creatinine assays are standard diagnostic tools for assessing kidney function.
    • Potential interference of medications with laboratory tests can lead to misdiagnosis.

    Purpose of the Study:

    • To investigate the effect of cefoxitin sodium on serum creatinine measurements.
    • To determine the reliability of creatinine tests in patients receiving cefoxitin.

    Main Methods:

    • In vitro experiments to assess cefoxitin's impact on creatinine assays.
    • Analysis of published data from human volunteer studies.
    • Evaluation of creatinine test reliability based on renal function and time post-infusion.

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    Main Results:

    • Cefoxitin sodium causes a dose-dependent, apparent increase in serum creatinine levels.
    • Observed increases ranged from 1.5 to over 8.5 times normal serum creatinine.
    • Similar interference was noted in urinary creatinine measurements, affecting creatinine clearance estimations.

    Conclusions:

    • Cefoxitin sodium significantly interferes with common creatinine assays.
    • Serum creatinine tests are unreliable in patients with severe renal failure receiving cefoxitin.
    • Timing of testing is crucial for reliability in patients with normal or mild-to-moderate renal function.