Therapeutic Research

Abstract

Background： Cefepime is a first‒line drug in the early‒stage empirical treatment of cases of infectious diseases such as nosocomial pneumonia and ventilator‒related pneumonia for which the causative organism has not been identified. However, the high frequency of drug‒induced liver injury（DILI）has become a clinical challenge. 　　Objective： The purpose of this study was to identify the risk factor for DILI development induced by cefepime before the start of treatment. 　　Method： We retrospectively extracted the data（age, sex, dose, treatment duration, and laboratory test values immediately before the start of treatment）of patients in whom cefepime treatment was initiated and performed univariate and multivariate logistic regression analyses of patients in whom DILI developed（DILI patients）and those in whom DILI did not develop（non‒DILI patients）. 　　Result： C‒reactive protein（odds ratio 1.127, 95％ confidence interval 1.017‒1.249, p＝0.023）and red blood cell count（odds ratio 1.014, 95％ confidence interval 1.003‒1.025, p＝0.015）before cefepime treatment were identified as risk factors for DILI development. 　　Conclusion： Among patients with high values of these risk factors, the possible treatment with other drugs should be considered, while the closer monitoring of liver function tests when cefepime is administered may prevent DILI onset and exacerbation.