Hepatotoxicity of Antibacterials: Pathomechanisms and Clinical Data

Abstract

Drug-induced hepatotoxicity is a frequent cause of liver disease and acute liver failure, particularly in patients treated with multiple drugs. Several antibacterial drugs have the potential to cause severe liver injury and failure. This article aims to increase the awareness and understanding of drug induced liver injury (DILI) due to antibacterial drugs. It reviews the pattern of antibacterial DILI and provides details on molecular mechanisms and toxicogenomics, as well as clinical data based on epidemiology studies. Certain antibacterial drugs are more frequently linked to hepatotoxicity than others. Therefore, the hepatotoxic potential of tetracyclines,sulfonamides, tuberculostatic agents, macrolides, quinolones,and beta-lactams are discussed in more detail. Efforts to improve the early detection of DILI and the acquisition of high-quality epidemiological data are pivotal for increased patient safety.

173 A Randomised Controlled Trial of Azithromycin Therapy in Bronchiolitis Obliterans Syndrome (BOS) Post Lung Transplantation

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“…Several drugs have been withdrawn from the market due to the severe adverse effects in patients [24][25][26]. Most of these drugs have shown potential to cause toxicity in healthy organs such as hepatotoxicity and nephrotoxicity [27][28][29].…”

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“…Дополнительно 14-членные макролиды (в том числе кларитромицин) ингибируют си-стему цитохрома-450, что приводит к накоплению токси-ческих метаболитов с непосредственным токсическим или опосредованным иммунологическим поражающим воздействием на печень [20]. Возможно развитие холеста-тического гепатита или дуктопении [21]. Кроме того, не-обходимо помнить о кардиотоксичности макролидов при их назначении.…”