Clinical Analysis of Acute Kidney Injury Caused by Combined Use of Vancomycin and Flurbiprofen Axetil
Objective:To analyze the occurrence,treatment measures and possible causes of acute kidney injury caused by combined use of vancomycin and flurbiprofen axetil,and provide a reference for the safe and rational use of vancomycin and flurbiprofen axetil in clinical practice.Methods and Results:The patient 1 underwent cardiothoracic surgery during hospitalization and was given flurbiprofen axetil for pain relieving after surgery.During this period,the patient's renal function indicators were normal.Later,due to wound infection,vancomycin was given.On the second day,the patient developed oliguria,and the levels of creatinine,urea nitrogen and urea increased significantly,which was considered to be acute kidney injury.These clinical manifestations progressively worsened in the next 2 days,so vancomycin and flurbiprofen axetil were discontinued clinically and symptomatic treatment was given.Later,the patient's urine volume and renal function indicators gradually improved to normal.The Naranjo's Assessment Scale showed that the patient's acute kidney injury was"probably"associated with vancomycin,and"possibly"associated with flurbiprofen axetil.The patient 2 underwent total knee arthroplasty;one and a half years later,the redness,swelling and pain symptoms occurred in the knee joint and calf,which was clinically considered to be caused by infection.So vancomycin was given for anti-infection and flurbiprofen axetil was given for relieving pain.From the 6th day,the patient's creatinine level increased progressively,and then the urea nitrogen level also became abnormal,which was considered acute kidney injury.On the 17th day,vancomycin and flurbiprofen axetil were discontinued clinically and symptomatic treatment was given.Later,the patient's creatinine level gradually decreased.The Naranjo's Assessment Scale showed that the patient's acute kidney injury was"possibly"associated with vancomycin and flurbiprofen axetil.Conclusion:Both vancomycin and flurbiprofen axetil may cause acute kidney injury.The combined use of them or even the superposition of other risk factors may increase the possibility of risk.Therefore,necessary risk assessment should be performed when nephrotoxic drugs are clinically used or used in combination to reduce the risk of related adverse drug reactions.
vancomycinflurbiprofen axetilacute kidney injuryadverse drug reactions
万方数据
维普
