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 21 May 2018

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News

Antibiotics are a major cause of drug-induced jaundice

Co-amoxiclav and flucloxacillin are major causes of drug-induced jaundice, finds January's European Journal of Gastroenterology & Hepatology.

News image

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Dr Sayed Hussaini and colleagues determined the incidence and causes of drug-induced jaundice in a rural community.

The investigative team undertook a retrospective analysis of 800 patients presenting to a single-center jaundice referral system from 1998 to 2004.

Standard criteria for drug-induced liver injury were applied to patients with a putative diagnosis of drug-induced jaundice.

The incidence rates per prescription of drug-induced jaundice caused by co-amoxiclav and flucloxacillin were derived from annual prescription rates.

The investigators found that the incidence of drug-induced jaundice was about 1 per 100 000 per annum in a total of 28 patients.

8% of patients with jaundice had an antibiotic-related etiology
European Journal of Gastroenterology & Hepatology

The team noted that antibiotics were the commonest cause of jaundice.

Of the antibiotics, co-amoxiclav and flucloxacillin caused the majority with an incidence rate per 100 000 prescriptions of 10 and 4, respectively.

The investigators observed co-amoxiclav-induced jaundice more commonly in elderly males.

In those patients with flucloxacillin or co-amoxiclav-induced jaundice, bilirubin ranged from 54 to 599 [mu]mol/l.

In these patients, the team noted that jaundice resolved within 30 to 90 days.

Counseling with regard to potential drug-induced liver injury, and reporting of the adverse reaction had been performed in 1 of 28 patients.

Dr Hussaini's team concludes, “We found that 8% of patients with no biliary obstruction and jaundice had a drug-induced and predominantly antibiotic-related etiology, particularly affecting an elderly population.”

“The team recommends that all patients receiving co-amoxiclav and flucloxacillin should be counseled before the therapy regarding the potential risk of jaundice.”

“An alternative antibiotic to co-amoxiclav is used if possible in men over the age of 60 years.”

Eur J Gastroenterol Hepatol 2007: 19(1): 15-20
15 January 2007

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