Hepatotoxic reactions to antibacterials are rare, occurring with an estimated frequency of between 1 and 10 per 100 000 drug prescriptions for most antibacterials.
Although many antibacterial-induced hepatotoxic reactions have a characteristic clinical and biochemical pattern e.g. cholestatic hepatitis (flucloxacillin) or fatty liver (tetracycline), many can also present with a variety of clinicopathological patterns e.g. nitrofurantoin is associated with the development of acute hepatitis, granulomatous hepatitis and chronic active hepatitis.
Almost all reactions are idiosyncratic, with no diagnostic laboratory tests to aid the diagnosis.
Early diagnosis is essential and requires a vigilant physician to elicit a detailed drug history.
Although the outcome is usually good when the offending antibacterial is withdrawn, morbidity may persist for years and fatalities have occurred, particularly when there is a delay in recognising the hepatotoxic antibacterial.
There is no specific treatment for antibacterial-induced hepatotoxicity other than withdrawing the implicated drug.
For severe disease, however, liver transplantation should be considered.
Mots-clés Pascal : Flucloxacilline, Tétracycline, Nitrofurantoïne, Céphalosporine dérivé, Pénicilline dérivé, Sulfamides, Macrolide, Toxicité, Hépatite, Cholostase, Stéatose, Homme, Antibiotique, Antibactérien, Chimiothérapie, Traitement, Quinolone dérivé, Fluoroquinolone dérivé, Tétracycline dérivé, Furane dérivé, Composé nitro, Incidence, Epidémiologie, Australie, Océanie, Prévention, Foie pathologie, Appareil digestif pathologie, Article synthèse
Mots-clés Pascal anglais : Cephalosporin derivatives, Penicillin derivatives, Sulfanilamide derivatives, Macrolide, Toxicity, Hepatitis, Cholostasis, Steatosis, Human, Antibiotic, Antibacterial agent, Chemotherapy, Treatment, Quinolone derivative, Fluoroquinolone derivative, Tetracycline derivatives, Furan derivatives, Nitro compound, Incidence, Epidemiology, Australia, Oceania, Prevention, Hepatic disease, Digestive diseases, Review
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0335620
Code Inist : 002B02U04. Création : 10/04/1997.