Effect of Ceftriaxone Dosage and Albumin–Bilirubin Score on the Risk of Ceftriaxone-Induced Liver Injury

抄録

The albumin–bilirubin (ALBI) score is an index of hepatic functional reserve and is calculated from serum albumin and total bilirubin levels. However, the relationship between ceftriaxone (CTRX)-induced liver injury and ALBI score remains unknown. Therefore, we aimed to elucidate the risk of CTRX-induced liver injury based on the ALBI scores and CTRX dosage. This was a single-center, retrospective, case-control study of 490 patients and the primary outcome was CTRX-induced liver injury. We performed a COX regression analysis using age ≥75 years, male sex, alanine aminotransferase levels, ALBI score, and CTRX dosage regimen (4 ≥2 or 1 g/d) as explanatory factors. We also performed 1 : 1 propensity score matching between non-liver injury and liver injury groups. The incidence of liver injury was 10.0% (49/490). In COX regression analysis, CTRX 4 g/d was an independent risk factor for liver injury (95% coefficient interval: 1.05–6.96, p = 0.04). Meanwhile, ALBI score ≥−1.61 was an independent factor for liver injury (95% coefficient interval: 1.03–3.22, p = 0.04) with the explanatory factor of ≥2 and 1 g/d. The Kaplan–Meier curve indicated that the cumulative risk for CTRX-induced liver injury was significantly higher in the ALBI score ≥−1.61 group than in the ALBI score <−1.61 group before propensity score matching (p = 0.032); however, no significant differences were observed after propensity score matching (p = 0.791). These findings suggest that in patients treated with CTRX with ALBI score ≥−1.61, frequent liver function monitoring should be considered.