毒理性
静脉滴注替卡西林治疗与轻度和暂时性血清转氨酶升高有关,这通常是自限性的,并且比比较抗生素稍微常见一些。更有报道指出,与替卡西林相似的羧苄青霉素类抗生素,具有更广泛的抗假单胞菌覆盖范围的羧苄青霉素,会导致无黄疸性肝损伤。接受高剂量静脉羧苄青霉素治疗的人不常见(15%至30%)出现无黄疸的血清转氨酶升高,停药或改用其他抗生素后迅速恢复正常。使用羧苄青霉素重新治疗时复发很常见,但使用替卡西林则不会。静脉注射苯唑西林也会出现类似现象。在接受替卡西林与克拉维酸联合治疗的人中,罕见有个别特异质、临床上明显的胆汁淤积性肝损伤的报道,其中一些与多种青霉素可能发生的罕见特异质反应相似,并且类似于阿莫西林/克拉维酸治疗后发生的胆汁淤积性肝损伤。
Intravenous ticarcillin therapy has been associated with mild and transient serum aminotransferase elevations that were generally self-limited and only slightly more common with ticarcillin than with comparative antibiotics. Much more commonly reported were instances of anicteric hepatic injury from carbenicillin, a similar carboxypenicillin with extend coverage against Pseudomonas. Persons receiving high doses of intravenous carbenicillin not uncommonly (15% to 30%) developed serum aminotransferase elevations without jaundice, which promptly fell to normal with discontinuation or switching to another antibiotic. Recurrence is common with retreatment using carbenicillin, but not with ticarcillin. A similar phenomenon occurs with intravenous oxacillin. Rare instances of idiosyncratic, clinically apparent cholestatic liver injury have been reported in persons receiving ticarcillin in combination with clavulanate, some of which resemble the rare idiosyncratic reactions that can occur with many penicillins and which resemble the cholestatic liver injury that occurs after amoxicillin/clavulanate.
来源:LiverTox