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Related Experiment Videos

Fulminant liver failure associated with clarithromycin.

Andreas Tietz1, Markus H Heim, Urs Eriksson

  • 1Department of Internal Medicine, University Hospital, Basel, Switzerland.

The Annals of Pharmacotherapy
|December 31, 2002
PubMed
Summary

A patient developed severe liver failure while taking clarithromycin for pneumonia. This drug-induced liver injury was likely caused by clarithromycin, possibly interacting with other medications, highlighting the risk of antibiotic-associated hepatotoxicity.

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Area of Science:

  • Hepatology
  • Pharmacology
  • Infectious Diseases

Background:

  • Pneumonia is a common respiratory infection often treated with antibiotics.
  • Macrolide antibiotics, such as clarithromycin, are frequently prescribed for pneumonia.
  • Drug-induced liver injury (DILI) is a significant concern in clinical practice.

Observation:

  • A 58-year-old woman developed fulminant liver failure during clarithromycin treatment for pneumonia.
  • The patient was also taking N-acetylcysteine, atenolol, and isradipine.
  • Exclusion of other causes, including viral, autoimmune, and toxic hepatitis, was performed.

Findings:

  • The patient recovered spontaneously after discontinuation of all medications, negating the need for liver transplantation.
  • Liver biopsy showed centroacinar necrosis, indicative of recent hepatic damage.

Related Experiment Videos

  • Clarithromycin was identified as the most probable cause of liver failure, either independently or through interaction with isradipine.

    • Implications:

    • This case suggests clarithromycin can cause severe, potentially fatal, liver injury.
    • Potential drug interactions, particularly with isradipine, may exacerbate clarithromycin's hepatotoxicity.
    • Clinicians should monitor for liver function abnormalities in patients treated with clarithromycin, especially those on multiple medications.