Acute kidney injury due to single time overdosage intravenous infusion of amoxicillin and clavulanate potassium: report of 2 cases

Abstract

Two female patients who aged 42 and 33 years with adenomyosis and hysteromyoma, respectively were hospitalized for surgical treatment. They had not history of kidney disease. They developed the symptoms of nausea, vomit, hematuresis, hypourocrinia, and slight puffy swelling after the second and fourth times of IV infusion of amoxicillin and clavulanate potassium 2.4 g, respectively. Laboratory examination showed the increase of serum creatinine (Scr) and urea nitrogen (BUN)(case 1: Scr 423 μmol/L, BUN 7.2 mmol/L; case 2: Scr 443 μmol/L, BUN 6.8 mmol/L). Amoxicillin and clavulanate potassium were stopped to use in both patients immediately and symptomatic treatments which included those for relieving vomiting, hemostasis, diuresis, and fluid infusion were given to them. The two patients were transferred to another hospital's nephrology department for hemodialysis on day 5 and 3 of receiving amoxicillin and clavulanate potassium, respectively. The two patients' urine volume, levels of Scr and BUN were returned to normal on day 18 and 20 after transferring, respectively (case 1: Scr 49 μmol/L, BUN 4.1 mmol/L; case 2: Scr 55 μmol/L, BUN 5.1mmol/L). Key words: Amoxicillin-potassium clavulanate combination; Acute kidney injury