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World J Clin Pediatr. Sep 9, 2022; 11(5): 405-407
Published online Sep 9, 2022. doi: 10.5409/wjcp.v11.i5.405
Rational use of antibiotics in children with diabetic ketoacidosis needs attention
Xu Wang
Xu Wang, Department of Endocrinology, Children's Hospital of Nanjing Medical University, Nanjing 210008, China
Author contributions: Wang X conceptualized and designed the study, and drafted and revised the manuscript.
Conflict-of-interest statement: All the authors declare that they have no competing interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xu Wang, MD, PhD, Doctor, Department of Endocrinology, Children's Hospital of Nanjing Medical University, No. 72 Guangzhou Road, Nanjing 210008, Jiangsu Province, China. sepnine@njmu.edu.cn
Received: March 14, 2022
Peer-review started: March 14, 2022
First decision: May 11, 2022
Revised: June 20, 2022
Accepted: July 8, 2022
Article in press: July 8, 2022
Published online: September 9, 2022
Processing time: 177 Days and 8.4 Hours
Abstract

Diabetic ketoacidosis (DKA) in children may lead to acute kidney injury (AKI). Among 45 children with DKA in our center, eight cases had AKI on admission, and in one child, his kidney function did not recover until 3 mo after discharge. This child was treated with antibiotics (cephalosporin), and we cannot rule out delayed AKI recovery due to the combined effects of the drug and the disease. Pediatricians should be concerned about the impact of nephrotoxic drug and disease interactions on children's kidney function, and need to follow up children with DKA and AKI to determine the development of AKI.

Keywords: Diabetic ketoacidosis; Acute kidney injury; Antibiotics; Nephrotoxic; Follow up

Core Tip: Pediatricians should pay attention to the prevention of further damage to kidney function in children with Diabetic ketoacidosis (DKA) and acute kidney injury (AKI), and it is necessary to rationally use PK model to achieve drug safety. It is of concern that children with DKA and AKI events must be followed up to determine the development of AKI. Risk factors that may further affect kidney function also need to be avoided.