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Prolonged hepatic cholestasis after flucloxacillin therapy.
I B Turner1, R P Eckstein, J W Riley
1Royal North Shore Hospital of Sydney, St Leonards, NSW.
The Medical Journal of Australia
|December 4, 1989
Summary
Flucloxacillin can cause severe, prolonged liver disease, including jaundice and itching, in some patients. This underdiagnosed condition may worsen as flucloxacillin use increases.
Area of Science:
- Hepatology
- Clinical Pharmacology
Background:
- Flucloxacillin is a widely used antibiotic.
- Drug-induced liver injury (DILI) is a significant concern.
Observation:
- Five patients developed severe, prolonged liver disease after flucloxacillin use.
- Symptoms included deep jaundice and debilitating pruritus, lasting over two months.
- Liver enzyme abnormalities persisted for 4-9 months post-exposure.
Findings:
- Liver biopsies revealed severe cholestasis in all patients.
- Three patients showed significant bile duct injury.
- One patient exhibited marked bile duct depletion after nine months.
Implications:
- Flucloxacillin-induced hepatotoxicity is likely underdiagnosed and underreported.
- Increasing flucloxacillin use may lead to more DILI cases.
- Clinicians should be vigilant for flucloxacillin hepatotoxicity.