Related Experiment Video

Updated: May 2, 2026

Inducing Acute Liver Injury in Rats via Carbon Tetrachloride CCl4 Exposure Through an Orogastric Tube
06:12

Inducing Acute Liver Injury in Rats via Carbon Tetrachloride CCl4 Exposure Through an Orogastric Tube

Published on: April 28, 2020

11.0K

Brief communication: severe hepatotoxicity of telithromycin: three case reports and literature review

Kimberly D Clay1, John S Hanson, Scott D Pope

  • 1Carolinas Medical Center, Charlotte Gastroenterology and Hepatology, Carolinas HealthCare System, and Carolinas Pathology Group, Charlotte, North Carolina 28203, USA. kimberly.clay@carolinashealthcare.org

Annals of Internal Medicine
|February 17, 2006
PubMed
Abstract

Insights

Telithromycin, a ketolide antibiotic, can cause severe liver damage (hepatotoxicity). This case series highlights three instances of acute hepatitis, with one fatality and one requiring liver transplantation, emphasizing the need for caution.

Area of Science:

  • Pharmacology
  • Hepatology
  • Infectious Diseases

Background:

  • Telithromycin is a U.S. Food and Drug Administration-approved ketolide antibiotic.
  • It is indicated for acute bacterial infections including sinusitis, bronchitis, and community-acquired pneumonia.

Observation:

  • Three previously healthy patients developed severe hepatotoxicity after taking telithromycin.
  • Patients presented with acute hepatitis, jaundice, and abnormal liver function tests within days of use.
  • Viral serology was negative in all cases.

Findings:

  • One patient recovered spontaneously, one died, and one required orthotopic liver transplantation.
  • Histologic examination revealed massive hepatic necrosis in two patients.
  • Two patients reported some history of alcohol use.

Implications:

  • Telithromycin can cause severe, potentially fatal, hepatotoxicity.
  • Prescribing telithromycin warrants caution due to the risk of severe liver injury.
  • Further postmarketing surveillance is crucial to establish the frequency of telithromycin-related hepatotoxicity.

More Related Videos

A Cell Culture Model for Producing High Titer Hepatitis E Virus Stocks10:28

A Cell Culture Model for Producing High Titer Hepatitis E Virus Stocks

Published on: June 26, 2020

9.4K
Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro11:06

Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro

Published on: January 31, 2022

7.6K

Related Concept Videos

Therapeutic Drug Monitoring: Affecting Factors01:29

Therapeutic Drug Monitoring: Affecting Factors

Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
429
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow01:26

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
382
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
271
Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment01:08

Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment

Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...
379
Drug Toxicity: Overview01:00

Drug Toxicity: Overview

Drug toxicity quantifies the harm a compound causes to an organism, varying by dose and potentially impacting whole systems or specific organs like the liver. Toxic reactions may arise from venomous insect or spider bites, with effects ranging from mild symptoms to severe outcomes such as brain damage or death. Common forms of acute poisoning include ethanol intoxication and overdose of pain or fever medications, with substances like GHB and heroin being particularly lethal at doses close to...
295
Drug Toxicity: Risk factors01:24

Drug Toxicity: Risk factors

Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
229