Cephalexin-induced acute tubular necrosis

Pharmacotherapy
Kristen L LongstrethNathaniel S Doe

Abstract

A 24-year-old woman with a history of penicillin allergy developed reversible acute renal failure after receiving cephalexin for 4 days. The patient experienced nausea, vomiting, diarrhea, pruritus, cough, and an elevated creatinine level of 2.2 mg/dl. The patient's creatinine level continued to rise, peaking at 5.3 mg/dl on hospital day 3. Nephrotoxic acute tubular necrosis was confirmed by electron microscopy. Within 1 month of discharge from the hospital, the patient's creatinine level decreased to 0.6 mg/dl. Although the renal injury most commonly associated with the cephalosporin class of antibiotics is allergic interstitial nephritis, currently available cephalosporins infrequently can cause direct tubular toxicity.

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Citations

Nov 1, 2011·Medizinische Klinik, Intensivmedizin und Notfallmedizin·M Haase, A Haase-Fielitz
Mar 5, 2011·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Vasilis TzovarasMoses Elisaf
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May 16, 2020·The Pediatric Infectious Disease Journal·Amanda GweeStephen B Duffull

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