Unlabelled: Although crystalluria is a frequent finding in the routine examination of urine, amoxicillin crystalluria is a rare event whose incidence remains unknown. Crystalluria caused by amoxicillin is very uncommon and may be asymptomatic or have severe renal implications. The authors describe the case of an 87-year-old female patient who presented with massive amoxicillin crystalluria due to poor hydration, low urinary pH and high intravenous amoxicillin dosage.
Learning Points: Amoxicillin crystalluria is a rare event.It can range from a transient asymptomatic crystalluria without renal damage to major haematuria or acute renal failure.We should be aware of this complication because high intravenous doses of amoxicillin are frequently prescribed and measures can be adopted to prevent this complication.
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http://dx.doi.org/10.12890/2017_000736 | DOI Listing |
Kidney Int
January 2025
Service of Nephrology, Ospedale Regionale di Locarno "La Carità," Ente Ospedaliero Cantonale, Locarno, Switzerland.
Clin Ther
December 2024
Department of Infectious Diseases, CHU Clermont-Ferrand, Clermont-Ferrand, France. Electronic address:
Purpose: High doses of amoxicillin are recommended to treat severe infections such as endocarditis. Amoxicillin causes dose-dependent toxicities, in particular crystal nephropathy. Toxicity could be avoided by monitoring of amoxicillin trough plasma concentrations (ATPC).
View Article and Find Full Text PDFKidney Int
January 2025
Sorbonne Université, UFR de médecine, Paris, France; Inserm UMR S 1155, Hôpital Tenon, Paris, France; Service des Explorations Fonctionnelles Multidisciplinaires, Hôpital Tenon, APHP, Paris, France. Electronic address:
Amoxicillin crystalluria (AC) refers to the precipitation of amoxicillin in the urine as amoxicillin trihydrate crystals. Amoxicillin-induced crystal nephropathy (AICN) refers to the obstruction of kidney tubules by amoxicillin trihydrate crystals, resulting in acute kidney injury. Usually considered rare and not serious, AC and AICN would be more frequent in patients receiving high-dose i.
View Article and Find Full Text PDFTher Adv Drug Saf
March 2022
School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK.
Introduction: Alkalising agents have the potential to enhance the efficacy of many antimicrobial agents used in the treatment of Urinary Tract Infections; they also have the potential to cause significant patient harm if used incorrectly. This work seeks to illustrate and quantify these risks and synergies by modelling drug solubility and supersaturation against pharmacokinetic data for commonly used antibiotic agents.
Methods: Solubility-pH relationships are employed to quantify the crystalluria risk for compounds which may be reasonably expected to be co-prescribed-or co-administered-with urinary alkalisers (amoxicillin, nitrofurantoin, trimethoprim, sulfamethoxazole and ciprofloxacin).
EClinicalMedicine
March 2022
Service de Médecine Interne- Maladies infectieuses, Immunologie Clinique. Centre Hospitalier Universitaire Robert Debré, Reims, France.
Background: Amoxicillin crystalluria (AC), potentially responsible for acute kidney injury (AKI), is reported more and more frequently in patients treated with high doses of intravenous amoxicillin (HDIVA). The main objective of this study was to evaluate AC incidence in these patients. The secondary objectives were to identify factors associated with AC and to evaluate its impact on the risk of AKI.
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