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Erythromycin base-induced rash and liver function disturbances.

H Shirin¹, J M Schapiro, N Arber

¹Department of Internal Medicine D, Sackler Faculty of Medicine, Tel Aviv University, Petah Tiqva, Israel.

The Annals of Pharmacotherapy

|December 1, 1992

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Erythromycin base can cause severe skin rash and liver problems, including jaundice. This case highlights the potential for hypersensitivity reactions to this antibiotic.

Area of Science:

Pharmacology
Hepatology
Dermatology

Background:

Erythromycin is a widely used antibiotic for bacterial infections.
Adverse reactions to macrolide antibiotics can include dermatological and hepatic manifestations.
Erythromycin derivatives have been associated with various side effects, necessitating careful monitoring.

Observation:

A patient presented with erythema nodosum and elevated antistreptolysin-O titers, treated with erythromycin.
Within 48 hours, the patient developed fever, a generalized rash, pruritus, and signs of cholestatic and hepatocellular liver injury.
Medical investigations could not identify other causes for the liver function disturbances.

Findings:

Erythromycin base administration led to the development of a severe rash and significant liver function abnormalities.

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Cessation of erythromycin therapy resulted in marked clinical improvement.

The constellation of symptoms suggests a hypersensitivity reaction as the likely mechanism.

Implications:

Erythromycin base should be recognized as a potential cause of drug-induced rash and liver injury.
Clinicians should consider hypersensitivity when patients exhibit fever, rash, jaundice, and liver dysfunction during erythromycin treatment.
This case underscores the importance of monitoring for adverse effects of commonly prescribed antibiotics.