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George DK, Crawford DH. Antibacterial-induced hepatotoxicity. Incidence, prevention and management. Drug Saf. 1996;15(1):79-85doi: 10.2165/00002018-199615010-00007.
George, D. K., & Crawford, D. H. (1996). Antibacterial-induced hepatotoxicity. Incidence, prevention and management. Drug safety, 15(1), 79-85. https://doi.org/10.2165/00002018-199615010-00007
George, D K, and Crawford, D H. "Antibacterial-induced hepatotoxicity. Incidence, prevention and management." Drug safety vol. 15,1 (1996): 79-85. doi: https://doi.org/10.2165/00002018-199615010-00007
George DK, Crawford DH. Antibacterial-induced hepatotoxicity. Incidence, prevention and management. Drug Saf. 1996 Jul;15(1):79-85. doi: 10.2165/00002018-199615010-00007. PMID: 8862966.
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Drug Saf. 1996 Jul;15(1):79-85. doi: 10.2165/00002018-199615010-00007.

Antibacterial-induced hepatotoxicity. Incidence, prevention and management.

Drug safety

D K George, D H Crawford

Affiliations

  1. Joint Liver Programme, University of Queensland, Australia.

PMID: 8862966 DOI: 10.2165/00002018-199615010-00007

Abstract

Hepatotoxic reactions to antibacterials are rare, occurring with an estimated frequency of between 1 and 10 per 100,000 drug prescriptions for most antibacterials. Although many antibacterial-induced hepatotoxic reactions have a characteristic clinical and biochemical pattern e.g. cholestatic hepatitis (flucloxacillin) or fatty liver (tetracycline), many can also present with a variety of clinicopathological patterns e.g. nitrofurantoin is associated with the development of acute hepatitis, granulomatous hepatitis and chronic active hepatitis. Almost all reactions are idiosyncratic, with no diagnostic laboratory tests to aid the diagnosis. Early diagnosis is essential and requires a vigilant physician to elicit a detailed drug history. Although the outcome is usually good when the offending antibacterial is withdrawn, morbidity may persist for years and fatalities have occurred, particularly when there is a delay in recognising the hepatotoxic antibacterial. There is no specific treatment for antibacterial-induced hepatotoxicity other than withdrawing the implicated drug. For severe disease, however, liver transplantation should be considered.

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