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Azithromycin-induced cholestatic hepatitis

Apostolos Koffas1,2, Iain M Murray-Lyon1, Roger Williams2

  • 1The Liver Centre, The London Clinic, London, UK.

Oxford Medical Case Reports
|June 6, 2017
PubMed

Insights

Azithromycin, an antibiotic, can rarely cause cholestatic hepatitis. A 69-year-old patient recovered after stopping the drug and receiving corticosteroids.

Area of Science:

  • Hepatology
  • Pharmacology
  • Internal Medicine

Background:

  • Azithromycin is a widely prescribed antibiotic known for its broad spectrum and favorable tolerability, particularly for short treatment durations (<7 days).
  • While generally safe, rare instances of azithromycin-induced liver injury, specifically cholestatic hepatitis, have been reported in medical literature.

Observation:

  • This case study details a 69-year-old male patient with a history of significant alcohol consumption.
  • The patient presented with jaundice after completing a 3-day course of azithromycin.

Findings:

  • A transjugular liver biopsy was performed for diagnostic evaluation.
  • The patient's liver function gradually improved and normalized approximately two months after azithromycin discontinuation.
  • Treatment with a short course of corticosteroids was initiated and contributed to the recovery.

Implications:

  • This case highlights a rare but serious adverse effect of azithromycin, emphasizing the importance of considering drug-induced liver injury in patients presenting with jaundice.
  • Clinicians should be vigilant for potential hepatotoxicity even with short-term antibiotic use.
  • Prompt recognition and management, including drug cessation and supportive care, are crucial for favorable outcomes in azithromycin-induced cholestatic hepatitis.

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