Effect of Ceftriaxone Dosage and Albumin–Bilirubin Score on the Risk of Ceftriaxone-Induced Liver Injury

The albumin–bilirubin (ALBI) score is an index of hepatic functional reserve and is calculated from serum albumin and total bilirubin levels. However, the relationship between ceftriaxone (CTRX)-induced liver injury and ALBI score remains unknown. Therefore, we aimed to elucidate the risk of CTRX-induced liver injury based on the ALBI scores and CTRX dosage. This was a single-center, retrospective, case-control study of 490 patients and the primary outcome was CTRX-induced liver injury. We performed a COX regression analysis using age ≥75 years, male sex, alanine aminotransferase levels, ALBI score, and CTRX dosage regimen (4 ≥2 or 1 g/d) as explanatory factors. We also performed 1 : 1 propensity score matching between non-liver injury and liver injury groups. The incidence of liver injury was 10.0% (49/490). In COX regression analysis, CTRX 4 g/d was an independent risk factor for liver injury (95% coefficient interval: 1.05–6.96, p = 0.04). Meanwhile, ALBI score ≥−1.61 was an independent factor for liver injury (95% coefficient interval: 1.03–3.22, p = 0.04) with the explanatory factor of ≥2 and 1 g/d. The Kaplan–Meier curve indicated that the cumulative risk for CTRX-induced liver injury was significantly higher in the ALBI score ≥−1.61 group than in the ALBI score