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Ceftazidime induced liver injury
Tayyab Shah1, James A Joslyn2, James Lai3
1Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA tayyab.shah@yale.edu.
Ceftazidime, an antibiotic for Pseudomonas aeruginosa infections, may rarely cause drug-induced liver injury. This case highlights the importance of monitoring liver function tests during treatment, even with other potential hepatotoxic medications present.
Area of Science:
- Pharmacology
- Hepatology
- Infectious Diseases
Background:
- A 65-year-old female with type II diabetes mellitus presented with non-healing ulcers and recurrent osteomyelitis.
- The patient experienced cellulitis progression despite prior amoxicillin-clavulanate treatment, indicating treatment failure.
Observation:
- Persistent osteomyelitis due to Pseudomonas aeruginosa infection was identified.
- Ceftazidime was initiated for treatment, but a rapid hepatocellular rise in liver function tests (LFTs) occurred after two doses.
Findings:
- Ceftazidime was discontinued due to potential hepatotoxicity, leading to prompt LFT normalization within 3 days.
- While other hepatotoxic medications were used, ceftazidime was identified as the most probable cause of drug-induced liver injury (DILI).
- The patient remained asymptomatic despite the significant elevation in LFTs.
Implications:
- This case underscores the rare but significant risk of ceftazidime-induced liver injury.
- Vigilant monitoring of liver function is crucial in patients receiving ceftazidime, especially those with comorbidities or on multiple medications.
- Further research into the mechanisms and incidence of ceftazidime DILI is warranted.
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