Amoxicillin-clavulanic acid–induced hepatitis

[Guest guest]

American Journal of Otolaryngology

Volume 28, Issue 1 , January 2007, Pages 28-30

Original contribution

Amoxicillin-clavulanic acid–induced hepatitis

Cundiff MD, a, and Joe MDa,

aDepartment of Otalaryngology-Head and Neck Surgery, University of Illinois,

Chicago, IL, USA

Received 17 March 2006. Available online 9 December 2006.

Abstract

Objectives

The aim of this study was to report a rare side effect of

amoxicillin-clavulanic acid resulting in drug-induced hepatitis in the

treatment of chronic rhinosinusitis.

Methods

This is a case report and literature review of amoxicillin-clavulanic

acid–induced hepatitis in the treatment of chronic rhinosinusitis. A MEDLINE

search of the published literature from 1966 to 2006 was performed using the

term “amoxicillin-clavulanic acid + hepatitis.”

Results

We report a case of a 53-year-old man who developed drug-induced hepatitis

after the use of amoxicillin-clavulanic acid for the treatment of chronic

rhinosinusitis. After a 4-week course of amoxicillin-clavulanic acid, the

patient developed pruritus and jaundice. Liver function tests revealed

elevated aminotransferase levels. Serologic examination result for hepatitis

A, B, and C was negative. The amoxicillin-clavulanic acid was discontinued

and the patient was treated conservatively. The pruritus and jaundice

gradually resolved and the patient had no long-term complications. The

literature review revealed this is the first reported case of

amoxicillin-clavulanic acid–induced hepatitis for the treatment of chronic

rhinosinusitis.

Conclusions

Drug-induced hepatitis is a rare side effect of amoxicillin-clavulanic acid.

Care must be taken in prescribing this drug to elderly patients and patients

with liver disease. In general, the hepatitis is mild to moderate, rarely

leads to liver failure, and can be managed conservatively.

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