Ciprofloxacin-induced acute liver injury: case report and review of literature

Abstract

Ciprofloxacin is a fluorinated quinolone antibiotic with relatively low occurrence of adverse side effects. However, increasing evidence suggests that ciprofloxacin may cause severe liver damage. Until now, 14 cases of ciprofloxacin-associated liver injuries have been reported. We describe a case of a 22-year-old male who developed hepatic failure after intake of ciprofloxacin. The patient had been treated with 2 x 250 mg ciprofloxacin per day. He presented with symptoms of acute liver failure 14 days later. Liver biopsy revealed extensive hepatocellular necrosis involving zones 3 and 2 of hepatic acini and a mixed inflammatory infiltration containing abundant eosinophils. Symptoms resolved after corticoidsteroid therapy. In the present paper, we report the clinico-pathological characteristics of a case of ciprofloxacin-associated acute hepatic failure and discuss the current literature.

Fluoroquinolone therapy and idiosyncratic acute liver injury: a population-based study

“…19,[23][24][25][26] Almost two-thirds of the patients in our case group filled their prescriptions in the 2 weeks before they were admitted to hospital, which is consistent with the rapid onset of liver injury reported in most published cases of fluoroquinolone -associated hepatotoxicity. [23][24][25][26] Although the precise mechanism of injury is unknown in our patients' cases, the latency period is consistent with many hypersensitivity reactions to drugs. 25,27 In our study, more than one-third of patients in the case group were admitted to hospital within 4 days of receiving a prescription for an antibiotic agent.…”

Risk of hepatotoxicity associated with fluoroquinolones: A national case–control safety study

“…4 With the exception of trovafloxacin, which was removed from the market due to a strong association with fatal acute liver failure, the literature supporting fluoroquinolone-induced hepatotoxicity is scant, mostly limited to case reports and reviews. [5][6][7][8][9][10][11][12][13][14] However, there have been selected reports of death from suspected fluoroquinoloneinduced hepatic failure. [15][16][17] The association between fluoroquinolones and hepatotoxicity remains unclear, and epidemiologic studies are needed to further assess this risk.…”

Detection of Ciprofloxacin in Urine through Sensitized Lanthanide Luminescence

“…The drug generally binds to the A subunit of the bacterial enzyme DNA gyrase and blocks DNA replication, which leads to rapid killing of bacteria through additional processes. Several side effects of Cipro as observed in humans include DNA damage [3], severe liver damage [4], and hematuria [5]. Also, Cipro is much less absorbed by the gastrointestinal tract in bioactive form than other fluoroquinolones [6].…”