INTERFERÊNCIA IN VITRO DA ADMINISTRAÇÃO DE CEFALOSPORINAS NOS VALORES DE CREATININA SÉRICA EM PACIENTES HOSPITALIZADOS

Abstract

Cephalosporins are antibiotics used for treating infections caused by Gram-negative and Gram-positive bacteria in both hospital and outpatient settings. Therefore, this study aimed to evaluate the impact of cephalosporins on serum creatinine levels in patients at a hospital in Natal, Brazil. To achieve this, an observational, prospective, cross-sectional, and analytical study was designed, submitted, and approved by the institution's Research Ethics Committee. The study population included adult patients who were admitted between May 2019 and March 2020 and were currently receiving medication. Critically ill patients, pregnant, and those undergoing antineoplastic or immunosuppressive therapy were excluded. Clinical data, medication prescriptions and blood samples for serum creatinine evaluation using the Jaffé reaction were collected upon admission. The results were subjected to statistical and in vitro analyses. Approximately 10% of the patients were using cephalosporins, which could potentially account for the observed increase in serum creatinine levels. The multiple regression model indicated that the administration of cephalosporins led to a mean increase of 0.61 mg/dL (95% CI 0.06 - 1.15) in serum creatinine levels. Specifically, the use of ceftriaxone was associated with an increase of 1.0 mg/dL (95% CI 0.32 - 1.69). Furthermore, the in vitro analysis revealed an 8.3% increase in serum creatinine levels in the presence of ceftriaxone, indicating a potential false elevation of this parameter in hospitalized patients receiving cephalosporins and assessed through the Jaffé method. Consequently, this study contributes to the establishment of clinical correlations between the use of cephalosporins and laboratory abnormalities, which are limited in the literature.