Voriconazole-Induced Cholestatic Hepatotoxicity in an Immune Competent Patient

Mohammed, Yaser N S; Abousamra, Ahmed; Abdeldayem, Ahmed Atef I; Zafar, Mansoor; Muhammad, Tila

doi:10.7759/cureus.21346

Cited by 1 publication

(1 citation statement)

References 13 publications

(10 reference statements)

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“…A study of a large healthcare system in California noted the incidence of voriconazole DILI to be 192 cases per 1,000 person-years, much higher than other azole antifungals. 236 The pattern of liver injury is variable, with both hepatocellular 237 and cholestatic 238,239 cases reported. Six cases of voriconazole DILI have been described by the DILIN.…”

Section: Voriconazole (Dili Likelihood Category B)mentioning

confidence: 99%

Hepatotoxicity of Antibiotics and Antifungals and Their Safe Use in Hepatic Impairment

Ma,

Björnsson,

Chalasani

2024

Semin Liver Dis

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Idiosyncratic drug-induced liver injury (DILI) is a rare and unpredictable form of hepatotoxicity. While its clinical course is usually benign, cases leading to liver transplantation or death can occur. Based on modern prospective registries, antimicrobials including antibiotics and antifungals are frequently implicated as common causes. Amoxicillin–clavulanate ranks as the most common cause for DILI in the Western World. Although the absolute risk of hepatotoxicity of these agents is low, as their usage is quite high, it is not uncommon for practitioners to encounter liver injury following the initiation of antibiotic or antifungal therapy. In this review article, mechanisms of hepatoxicity are presented. The adverse hepatic effects of well-established antibiotic and antifungal agents are described, including their frequency, severity, and pattern of injury and their HLA risks. We also review the drug labeling and prescription guidance from regulatory bodies, with a focus on individuals with hepatic impairment.

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