Analysis of children who received anticancer agent therapy, underwent stem cell transplantation, and were treated with metronidazole injection at our institute, including a case of interaction between tacrolimus and metronidazole

Souji Ibuka; Kanako Iino; Kohei Higuchi; Mariko Shimizu; Akihiro Asahara; Misaki Morisaki; Momoka Maruishi; Chikako Inaoka; Futoshi Fujiwara; Makie Kinoshita; Yasuharu Hirano; Hiroyuki Yamada; Takeshi Hatachi; Tomoki Nishikido; Narutaka Mochizuki; Noriaki Usui; Masami Inoue

doi:10.11412/jspho.56.172

Original Article

Analysis of children who received anticancer agent therapy, underwent stem cell transplantation, and were treated with metronidazole injection at our institute, including a case of interaction between tacrolimus and metronidazole

Souji Ibuka, Kanako Iino, Kohei Higuchi, Mariko Shimizu, Akihiro Asahara, Misaki Morisaki, Momoka Maruishi, Chikako Inaoka, Futoshi Fujiwara, Makie Kinoshita, Yasuharu Hirano, Hiroyuki Yamada, Takeshi Hatachi, Tomoki Nishikido, Narutaka Mochizuki, Noriaki Usui, Masami Inoue

Author information

Souji Ibuka
Hospital infection control team, Osaka Women’s and Children’s Hospital
Department of Pediatric Surgery, Osaka Women’s and Children’s Hospital
Department of Pediatric Surgery, National Hospital Organization Fukuyama Medical Hospital
Kanako Iino
Hospital infection control team, Osaka Women’s and Children’s Hospital
Department of Pharmaceuticals, Osaka Women’s and Children’s Hospital
Kohei Higuchi
Hospital infection control team, Osaka Women’s and Children’s Hospital
Department of Hematology/Oncology, Osaka Women’s and Children’s Hospital
Mariko Shimizu
Department of Hematology/Oncology, Osaka Women’s and Children’s Hospital
Akihiro Asahara
Hospital infection control team, Osaka Women’s and Children’s Hospital
Department of Pharmaceuticals, Osaka Women’s and Children’s Hospital
Misaki Morisaki
Hospital infection control team, Osaka Women’s and Children’s Hospital
Momoka Maruishi
Hospital infection control team, Osaka Women’s and Children’s Hospital
Chikako Inaoka
Hospital infection control team, Osaka Women’s and Children’s Hospital
Futoshi Fujiwara
Hospital infection control team, Osaka Women’s and Children’s Hospital
Makie Kinoshita
Hospital infection control team, Osaka Women’s and Children’s Hospital
Yasuharu Hirano
Hospital infection control team, Osaka Women’s and Children’s Hospital
Hiroyuki Yamada
Hospital infection control team, Osaka Women’s and Children’s Hospital
Takeshi Hatachi
Hospital infection control team, Osaka Women’s and Children’s Hospital
Tomoki Nishikido
Hospital infection control team, Osaka Women’s and Children’s Hospital
Narutaka Mochizuki
Hospital infection control team, Osaka Women’s and Children’s Hospital
Noriaki Usui
Department of Pediatric Surgery, Osaka Women’s and Children’s Hospital
Masami Inoue
Hospital infection control team, Osaka Women’s and Children’s Hospital
Department of Hematology/Oncology, Osaka Women’s and Children’s Hospital

Keywords: children, metronidazole injection, Clostridioides (Clostridium) difficile-associated diarrhea, tacrolimus

JOURNAL FREE ACCESS

2019 Volume 56 Issue 2 Pages 172-175

DOI https://doi.org/10.11412/jspho.56.172

Details

Abstract

The appropriate dosage and most suitable administration method for metronidazole (MNZ) in children have not yet been established. Furthermore, the safety and efficacy of MNZ injection in children have not been determined. In this study, we sought to provide data regarding the administration method and the effect, safety, and so forth of MNZ injection. Therefore, children under the age of 15 years who received anticancer agent therapy and underwent stem cell transplantation treated with MNZ injection in the two years from 1 July 2014 to 30 June 2016 at our institute were examined retrospectively. The patients’ characteristics, method of drug administration, drug administration period, dosage, efficacy, side effects, and antimicrobial agents used before were analyzed. Four patients between the ages of 2 and 10 years (median: 8 years 5 months) with six episodes were included. All the patients with episodes received a 20-min infusion of 10 mg of MNZ injection per kg body weight every 8 h. The underlying diseases were acute lymphocytic leukemia in two patients, chronic granulomatous disease in one, and nephroblastoma in the other. The administration period was between 3 and 15 days (median: 9 days), and the total number of MNZ injections was between 6 and 43 (median: 23.5). The total dose was between 900 and 17,200 mg (median: 4,750 mg). Treatment was successful for all the patients with episodes. Side effects (elevation of blood tacrolimus levels) were noted in only one patient; that patient had been receiving oral tacrolimus therapy. Although a small number of episodes were examined, MNZ injection was found to be relatively safe and effective by considering concomitant medication.

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