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Updated: Jun 13, 2026

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

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

Published on: January 31, 2022

Azithromycin-induced liver injury.

Alissa M Lockwood¹, Sabrina Cole, Marina Rabinovich

¹Department of Pharmacy and Drug Information, Parkland Health and Hospital System, Dallas, TX 75235, USA. alissalockwood@yahoo.com

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists

|May 19, 2010

Summary

This case report details azithromycin-induced liver injury in a 69-year-old woman. High-dose azithromycin for bronchitis led to cholestatic hepatitis, highlighting potential drug toxicity.

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Area of Science:

Hepatology
Pharmacology
Internal Medicine

Background:

Azithromycin is a widely prescribed macrolide antibiotic.
Drug-induced liver injury (DILI) is a significant clinical concern.
Cholestatic hepatitis is a specific pattern of liver damage.

Observation:

A 69-year-old woman presented with jaundice, pruritus, nausea, vomiting, and diarrhea.
Elevated liver enzymes (transaminitis) and an elevated International Normalized Ratio were noted.
Medical history included hypertension, hypothyroidism, depression, dyslipidemia, and COPD, with no prior liver disease.

Findings:

Liver injury was temporally associated with high-dose azithromycin therapy for suspected bronchitis.
Other causes of liver injury, including viral, metabolic, autoimmune, and ischemic hepatitis, were excluded.
Diagnostic scales indicated a probable azithromycin-associated drug-induced liver disease, specifically cholestatic hepatitis.

Implications:

This case underscores the potential for azithromycin to cause hepatotoxicity, even in patients without pre-existing liver conditions.
Clinicians should consider azithromycin as a potential cause of liver injury in patients presenting with compatible symptoms.
Further vigilance and investigation into antibiotic-associated liver injury are warranted.