Acute cholestatic hepatitis caused by amoxicillin/clavulanate

Amoxicillin/clavulanate is a synthetic penicillin that is currently commonly used, especially for the treatment of respiratory and cutaneous infections. in general, it is a well-tolerated oral antibiotic. However, amoxicillin/clavulanate can cause adverse effects, mainly cutaneous, gastrointestinal,...

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Detalles Bibliográficos
Autores: Beraldo, Daniel Oliveira [UNIFESP], Melo, Joanderson Fernandes, Bonfim, Alexandre Vidal [UNIFESP], Teixeira, Andrei Alkmim [UNIFESP], Teixeira, Ricardo Alkmim, Duarte, Andre Loyola
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2013
País:Brasil
Institución:Universidade Federal de São Paulo (UNIFESP)
Repositorio:Repositório Institucional da UNIFESP
Idioma:inglés
OAI Identifier:oai:repositorio.unifesp.br:11600/37081
Acceso en línea:http://dx.doi.org/10.3748/wjg.v19.i46.8789
http://repositorio.unifesp.br/handle/11600/37081
Access Level:acceso abierto
Palabra clave:Hepatology
Hepatitis
Amoxicillin/Clavulanate
Drug reactions
Hyperbilirubinemia
Descripción
Sumario:Amoxicillin/clavulanate is a synthetic penicillin that is currently commonly used, especially for the treatment of respiratory and cutaneous infections. in general, it is a well-tolerated oral antibiotic. However, amoxicillin/clavulanate can cause adverse effects, mainly cutaneous, gastrointestinal, hepatic and hematologic, in some cases. Presented here is a case report of a 63-year-old male patient who developed cholestatic hepatitis after recent use of amoxicillin/clavulanate. After 6 wk of prolonged use of the drug, he began to show signs of cholestatic icterus and developed severe hyperbilirubinemia (total bilirubin > 300 mg/L). Diagnostic investigation was conducted by ultrasonography of the upper abdomen, serum tests for infection history, laboratory screening of autoimmune diseases, nuclear magnetic resonance (NMR) of the abdomen with bile duct-NMR and transcutaneous liver biopsy guided by ultrasound. the duration of disease was approximately 4 mo, with complete resolution of symptoms and laboratory changes at the end of that time period. Specific treatment was not instituted, only a combination of anti-emetic (metoclopramide) and cholestyramine for pruritus. (C) 2013 Baishideng Publishing Group Co., Limited. All rights reserved.