Rapid-Onset Drug-Induced Liver Injury Following Amoxicillin-Clavulanate: A Case Report

Area of Science:

• Pharmacology
• Hepatology
• Clinical Toxicology

Background:

• Drug-Induced Liver Injury (DILI) is a rare adverse effect of medications.
• Amoxicillin-Clavulanate (A-C) is a common cause of idiosyncratic DILI, particularly in Western populations.
• DILI cases are less frequently reported in some regions, and diagnosis requires a high index of suspicion.

Purpose of the Study:

• To report a case of atypically rapid onset DILI.
• To highlight the potential for rapid liver injury from Amoxicillin-Clavulanate.
• To emphasize the importance of considering DILI even with short-term antibiotic exposure.

Main Methods:

• Case report of a 32-year-old female patient.
• Review of clinical presentation and medication history.
• Diagnosis of DILI based on exclusion criteria and temporal relationship to A-C administration.

Main Results:

• The patient experienced liver injury after only two doses of Amoxicillin-Clavulanate.
• This onset is significantly faster than the typical presentation of DILI (days to weeks).
• The case demonstrates an atypical, rapid-onset idiosyncratic reaction to A-C.

Conclusions:

• Amoxicillin-Clavulanate can cause rapid DILI, challenging typical onset expectations.
• Clinicians should maintain a high suspicion for DILI, irrespective of the duration of A-C use.
• This case underscores regional variations in DILI reporting and presentation.