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Possible roxithromycin-induced fulminant hepatic failure in a child

K L Easton-Carter1, W Hardikar, A L Smith

  • 1Department of Pharmacy, Royal Children's Hospital, Melbourne, Victoria, Australia.

Pharmacotherapy
|July 11, 2001
PubMed

Insights

A new pediatric antibiotic, roxithromycin, caused severe liver injury in a 5-year-old boy, necessitating a liver transplant. This highlights the potential for serious hepatic complications in children treated with this drug.

Area of Science:

  • Pediatric Pharmacology
  • Hepatology
  • Infectious Diseases

Background:

  • Roxithromycin is a macrolide antibiotic recently available in pediatric formulations in Australia.
  • A healthy 5-year-old boy received roxithromycin for common childhood symptoms.

Observation:

  • The child developed a generalized rash and vomiting post-treatment.
  • Subsequent symptoms included jaundice, dark urine, and pale stools, indicating liver dysfunction.

Findings:

  • Laboratory tests confirmed acute hepatitis.
  • The patient's condition rapidly deteriorated, leading to liver transplantation.

Implications:

  • Clinicians must recognize the risk of severe hepatic complications associated with pediatric roxithromycin use.
  • This case underscores the importance of monitoring liver function in children receiving roxithromycin.
  • Further research into the hepatotoxicity of roxithromycin in pediatric populations is warranted.

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