정상 간기능을 가진 방광암환자에서 간효소 수치를 올리는 Tosufloxacin Tosylate: 증례보고

Abstract

Summary: We report the first hepatic adverse effect of tosufloxacin tosylate in a muscle invasive bladder cancer patient with normalliver functions and with scheduling to undergo a surgical operation for a neobladder. Tosufloxacin tosylate 150 mg was administeredto a 57-year-old man who maintained transurethral resection of bladder tumor (TUR-BT) postoperative multiple medications. Hislabs presented significant increases in alanine amino transferase (ALT) and aspartate amino transferase (AST) levels with 2-weekcompliance of 150 mg tablet three times a day. After discontinuing tosufloxacin tosylate, the levels slowly decreased and completelyreturned to normal ranges without any intervention in a few weeks. The Naranjo Causality Algorithm indicates a probablerelationship between increased ALT and tosufloxacin. The patient was to have the second surgical operation as scheduled aftergetting normal range of ATL level. Therefore, tosufloxacin should be avoided in patients at risk for having liver dysfunctions ordiseases if the patients have a schedule for any operation. Background: Tosufloxacin tosylate has been shown to have favorablebenefits as an antibiotic. Tosufloxacin tosylate may be considered to have the adverse effects such as nauseas, vomiting, diarrhea,abdominal pain, stomatitis, tendonitis, tendon rupture, headache, dizziness, drowsiness, insomnia, weakness, agitation includinghemolysis in the event of glucose-6-phosphate dehydrogenase deficiency as other fluoroquinolones. More severe adversereactions of tosufloxacin tosylate over the above common adverse effects of fluoroquinolones were thrombocytopenia and nephritis. It also is not well known that tosufloxacin can cause hepatic problem. Here the study reports the first hepatic reaction fromtosufloxacin and might arouse heath care providers' attention to appropriate drug choice for patients.