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Augmentin-induced jaundice with a fatal outcome
G S Hebbard1, K G Smith, P R Gibson
1Department of Gastroenterology, Royal Melbourne Hospital, VIC.
The Medical Journal of Australia
|February 17, 1992
Summary
Augmentin can cause severe cholestatic hepatitis, a condition that is usually reversible but can be fatal. This case highlights a potential drug interaction between Augmentin and estrogen therapy, which may worsen the liver injury.
Area of Science:
- Hepatology
- Pharmacology
- Drug-induced liver injury
Background:
- Augmentin (amoxicillin/clavulanate) is a commonly prescribed antibiotic.
- Estrogenic steroids are used in treating conditions like prostatic malignancy.
- Drug-induced liver injury (DILI) poses a significant clinical challenge.
Observation:
- An 81-year-old male on ethinyloestradiol therapy for prostate cancer developed obstructive jaundice post-Augmentin treatment.
- Liver biopsy confirmed drug-induced cholestatic hepatitis with bile duct injury.
- The patient experienced progressive jaundice, hepatic encephalopathy, and did not respond to prednisolone.
Findings:
- Augmentin-induced cholestatic hepatitis can be severe and potentially fatal.
- Concurrent use of ethinyloestradiol may increase susceptibility or severity of Augmentin-induced liver injury.
- This case underscores the potential for serious adverse drug reactions even with common medications.
Implications:
- Clinicians should be vigilant for cholestatic hepatitis in patients using Augmentin, especially those on estrogen therapy.
- Further research into drug interactions between antibiotics and hormonal therapies is warranted.
- This case emphasizes the importance of considering drug-induced liver injury in unexplained jaundice.