Official websites use. Share sensitive information only on official, secure websites. Amoxicillin crystalluria AC , potentially responsible for acute kidney injury AKI , is reported more and more frequently in patients treated with high doses of intravenous amoxicillin HDIVA. The main objective of this study was to evaluate AC incidence in these patients. The secondary objectives were to identify factors associated with AC and to evaluate its impact on the risk of AKI.
Clinical, biological, and therapeutic characteristics of the patients were collected. A univariable mixed logistic regression model assessed the factors associated with AC. A multivariable Cox model with AC as a time-dependent variable assessed the prognostic factors for AKI.
Of the included patients, 27 Keywords: Amoxicillin, crystalluria, acute kidney injury, incidence, cohort study. Amoxicillin is known to cause urine crystallization. Amoxicillin crystalluria AC usually occurs with high-dose amoxicillin therapy, in urines with high density and low pH. It can be asymptomatic or can be responsible for hematuria or acute renal failure.
Mechanisms are currently uncertain but it may be attributable to intratubular precipitation or urinary tract obstruction. However, its incidence has been unknown up until now. In a cohort of patients treated with high doses of intravenous amoxicillin and tested systematically for AC, 27 developed at least one episode of AC, which was very strongly predictive of the subsequent occurrence of acute kidney injury. These results may encourage clinicians to change their attitude toward the screening and prevention of this underrated adverse effect of a frequently prescribed drug.
Future research is needed for the prevention of this event and to assess whether angiotensin-converting enzyme inhibitors are associated with its occurrence. Amoxicillin, because of its wide range of indications, is one of the most widely prescribed antibiotics worldwide. AC was described for the first time in in a study evaluating renal excretion of intravenous IV amoxicillin: immediately after administration of 2. AC is described in patients treated with amoxicillin, with or without clavulanic acid, dispensed by mouth or intravenous, for curative or prophylactic use.
