Fulminant Hepatic Failure Associated With Intravenous Erythromycin Lactobionate

Gholson, Charles F.

doi:10.1001/archinte.1990.00390130175030

Cited by 32 publications

(12 citation statements)

References 8 publications

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“…However, the change is mild and re versible and lacks clinical relevance [19], In rare cases, erythromycin has been reported to induce clinical hepatitis [20]. In the present trial both S-ALAT and S-y-GT values were in creased.…”

Section: Discussionmentioning

confidence: 43%

Efficacy and Tolerance of Erythromycin Acistrate in the Treatment of Acute Exacerbations of Chronic Bronchitis in the Elderly

Forsén¹,

Wikberg

Lehtonen

1993

Chemotherapy

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This randomized, investigator-blind, parallel-group trial compared erythromycin acistrate (EA) and erythromycin base (EB) in the treatment of elderly patients with acute exacerbations of chronic bronchitis. In total, 57 hospitalized patients were included, of whom 28 received EA 400 mg three times daily, and 29 EB 500 mg three times daily for 10-21 days. The mean age of the patients was 70 and 68 years in the EA and EB groups, respectively. The patients underwent medical examination before the onset of the study, at the 7th day during the treatment and 3-5 days after termination of the treatment. The efficacy assessment was based on clinical signs and symptoms of infection as well as on bacteriological culture from sputum samples. 55% of the patients in the EA group and 61% in the EB group were totally cured, 23 and 29%, respectively, had only mild symptoms at the end of the therapy and 14 versus 11% of the patients did not respond at all. The predominant pathogens isolated from sputum were Haemophilus influenzae, Bran-hamella catarrhalis and Streptococcus pneumoniae. 60% of the patients in the EA group and 46% in the EB group from whom a sample was taken had normal flora in the posttreatment culture. In the EA group, 8 patients and in the EB group 7 patients complained of gastrointestinal side effects and 4 and 1, respectively, discontinued the treatment prematurely. Slight, reversible elevations of one or more liver parenchymal enzyme activities during and after treatment were seen at the same frequency in both treatment groups. The results show that EA is as effective and well tolerated as EB in the treatment of exacerbations of chronic bronchitis in elderly patients.

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Section: Discussionmentioning

confidence: 43%

Efficacy and Tolerance of Erythromycin Acistrate in the Treatment of Acute Exacerbations of Chronic Bronchitis in the Elderly

Forsén¹,

Wikberg

Lehtonen

1993

Chemotherapy

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“…In the majority of cases, the recovery is complete, although cases of ductopenia have been described [91]. Although there has been one fatal case [92], the short-term prognosis is good. In a recent study that analyzed all the suspected cases of hepatotoxicity reported to the Swedish Pharmacovigillance Agency during the period between 1970 and 2004, there had not been any deaths among the 32 patients with erythromycinassociated hepatocellular lesions, in contrast to other drugs (including antibiotics) that exhibited this pattern of lesion [11].…”

Section: D) Macrolidesmentioning

confidence: 98%

Antibiotic-Induced Liver Toxicity: Mechanisms, Clinical Features and Causality Assessment

Robles

Toscano²,

Cotta³

et al. 2010

CDS

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Antibiotics are the therapeutic agents most often associated with hepatotoxicity. However, this is mainly due to the widespread prescription of these drugs. The relative risk of antibiotic-related hepatotoxicity is low. Causality assessment of suspected drug-induced liver injury (DILI) related to antibiotics can be difficult, particularly because some cases occur long after the drug has been stopped. Among the penicillins, amoxicillin clavulanate is the most associated with hepatotoxicity and is the most frequent cause of DILI-related hospitalisations. Flucloxacillin ranks as the second highest cause of DILI in many countries. The severity of antibiotic-induced DILI varies widely, with the hepatitis-like (hepatocellular) damage tending to be more severe that than cholestatic/mixed type. The pattern is strongly influenced by age. Recently telithromycin (a new generation macrolide) has been linked with DILI, with a typical pattern, which includes abrupt commencement of fever, abdominal pain, jaundice and, in some cases, ascites. Antibiotic-induced DILI appears, in most instances, to be idiosyncratic. Genetic-association studies have recently identified genotypes related to flucloxacillin and possibly to amoxicillin-clavulanate hepatotoxicity.

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“…The authors hypothesize a direct toxicity of clarithromycin or an interaction between clarithromycin and isradipine, potentially increasing the hepatic toxicity of isradipine. (17) Since several cases of liver failure have been described for other macrolide antibiotics such as erythromycin (18,19) or roxithromycin, (20,21) the macrolide structure may be responsible for hepatocellular injury. In vitro studies (22,23) suggest that the formation of toxic metabolites by cytochrome P450 followed by local depletion of glutathione may be a cause for hepatocellular injury due to macrolide antibiotics.…”

Section: Brief Communicationmentioning

confidence: 99%

Fatal fulminant hepatitis following administration of clarithromycin in a patient chronically treated with antipsycotic drugs

Maggi

Solarino

Cassano

et al. 2012

Immunopharmacology and Immunotoxicology

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Fulminant Hepatic Failure Associated With Intravenous Erythromycin Lactobionate

Cited by 32 publications

References 8 publications

Efficacy and Tolerance of Erythromycin Acistrate in the Treatment of Acute Exacerbations of Chronic Bronchitis in the Elderly

Efficacy and Tolerance of Erythromycin Acistrate in the Treatment of Acute Exacerbations of Chronic Bronchitis in the Elderly

Antibiotic-Induced Liver Toxicity: Mechanisms, Clinical Features and Causality Assessment

Fatal fulminant hepatitis following administration of clarithromycin in a patient chronically treated with antipsycotic drugs

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