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Antibiotic-associated hepatitis: update from 1990

T Vial1, M Biour, J Descotes

  • 1Service de Pharmaco-Toxicovigilance et Centre Anti-Poisons, Pavillon N, Hôpital Edouard Herriot, Lyon, France.

The Annals of Pharmacotherapy
|February 1, 1997
PubMed
Summary
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Antibiotic-associated acute liver injury is rare. Penicillinase-resistant penicillins, roxithromycin, ciprofloxacin, and trimethoprim are linked to protracted cholestasis and bile duct injuries.

Area of Science:

  • Hepatology
  • Pharmacology
  • Gastroenterology

Background:

  • Antibiotic-associated acute liver injury (AALI) is a significant concern.
  • Understanding the spectrum of AALI is crucial for patient safety.

Purpose of the Study:

  • To review recent evidence on antibiotic-associated acute liver injury.
  • To identify specific antibiotics linked to liver damage.

Main Methods:

  • Literature review of articles from January 1990 to July 1995.
  • Utilized HEPATOX, MEDLINE, EMBASE, and PASCAL databases.
  • Focused on case reports, series, and epidemiologic data, excluding certain drug classes.

Main Results:

  • AALI is rare, with incidence generally below 1 in 10,000 users.

Related Experiment Videos

  • Amoxicillin/clavulanic acid and penicillinase-resistant penicillins cause cholestasis.
  • Roxithromycin, ciprofloxacin, and trimethoprim are identified as potentially hepatotoxic.

    • Conclusions:

    • Protracted liver cholestasis and bile duct injuries are associated with several antibiotics, especially penicillinase-resistant penicillins.
    • Newer antibiotics like roxithromycin, ciprofloxacin, and trimethoprim require careful monitoring for hepatotoxicity.