Determinants of the clinical expression of amoxicillin-clavulanate hepatotoxicity: A prospective series from Spain

Recurrent cholestasis by amoxicillin-clavulanic acid: The importance of a correct diagnosis of hepatotoxicity

“…The average period of latency in Spanish patients is 3 weeks; however, it may be delayed until the end of treatment in almost a 50%, as was the case of the patient here reported (7). In general, it has a mild evolution after the drug removal, with the normalization of the laboratory tests in 1-4 months.…”

Mitochondrial and immunoallergic injury increase risk of positive drug rechallenge after drug-induced liver injury: A systematic review

“…2,4 Administered at a high daily dose of 500-3,000 mg, 26 amoxicillin/clavulanate is frequently associated with cholestatic or mixed disease; only 36% of patients exhibit hepatocellular injury. 41 Hypersensitivity was observed in 38% of amoxicillin/clavulanate-associated DILI in the prospective Spanish DILI Registry. 41 In further support of immunoallergic injury, two HLA markers are associated with amoxicillin/clavulanateassociated liver injury: HLA DQB1*0602 23 and HLA DRB1*1501.…”

“…41 Hypersensitivity was observed in 38% of amoxicillin/clavulanate-associated DILI in the prospective Spanish DILI Registry. 41 In further support of immunoallergic injury, two HLA markers are associated with amoxicillin/clavulanateassociated liver injury: HLA DQB1*0602 23 and HLA DRB1*1501. 19 Therefore, amoxicillin/clavulanate's rechallenge injury is primarily immunoallergic.…”

Toxicidad hepática causada por medicamentos: revisión estucturada

“…En el caso de las formas farmacéuticas combinadas de antibióticos, como trimetoprima/sulfametoxazol y amoxicilina/ácido clavulánico, se identificaron casos de toxicidad hepática, de tipo idiosincrásico y clasificada como probable (57). El evento se presentó principalmente en hombres, causando ictericia y prurito; en algunos casos de amoxicilina/ácido clavulánico, el desenlace fue trasplante hepático o muerte (89). El esquema antirretroviral tos tienen mayor evidencia de ser sustancias causantes de toxicidad hepática, aunque para algunas sea escasa la información precisa del mecanismo que explica el desarrollo y aparición del evento.…”