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Cholestatic hepatitis due to antibacterial combination of amoxicillin and clavulanic acid (Augmentin)

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Abstract

Five case histories are presented of patients developing cholestatic hepatitis associated with the intake of the antibiotic combination agent amoxicillin and clavulanic acid (Augmentin). In two of these cases, signs of hepatic injury recurred after readministration of this combination but not after the intake of amoxicillin alone. In none of the patients was another cause for cholestatic hepatitis found and extrahepatic causes were excluded by ultrasonography, CT scanning, or ERCP. Most viral causes of hepatic injury were excluded in these patients. With the exception of one patient, who developed a transient rash, no immunoallergic signs were present. Biopsy in two patients showed extensive cholestasis without significant necrosis. Clavulanic acid seems to be responsible for this adverse effect.

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Authors and Affiliations

  1. The Netherlands Centre for Monitoring of Adverse Reactions to Drugs, P.O. Box 5406, 2280 HK, Rijswijk, The Netherlands

    B. H. Ch. Stricker MB, PhD, J. W. G. Van Den Broek, J. Keuning, W. Eberhardt, H. G. J. Houben, M. Johnson & A. P. R. Blok

  2. Department of Internal Medicine II, Rotterdam, The Netherlands

    B. H. Ch. Stricker MB, PhD, J. W. G. Van Den Broek, J. Keuning, W. Eberhardt, H. G. J. Houben, M. Johnson & A. P. R. Blok

  3. Wanroy, The Netherlands

    B. H. Ch. Stricker MB, PhD, J. W. G. Van Den Broek, J. Keuning, W. Eberhardt, H. G. J. Houben, M. Johnson & A. P. R. Blok

  4. Department of Internal Medicine, St. Joseph Hospital, Eindhoven, The Netherlands

    B. H. Ch. Stricker MB, PhD, J. W. G. Van Den Broek, J. Keuning, W. Eberhardt, H. G. J. Houben, M. Johnson & A. P. R. Blok

  5. Department of Pediatrics, University of Erlangen-Nürnberg, Federal Republic of Germany

    B. H. Ch. Stricker MB, PhD, J. W. G. Van Den Broek, J. Keuning, W. Eberhardt, H. G. J. Houben, M. Johnson & A. P. R. Blok

  6. Department of Internal Medicine, St. Joseph Hospital, Kerkrade, The Netherlands

    B. H. Ch. Stricker MB, PhD, J. W. G. Van Den Broek, J. Keuning, W. Eberhardt, H. G. J. Houben, M. Johnson & A. P. R. Blok

  7. Department of Medicine, Veterans Administration Medical Center and Georgetown University, Washington, DC

    B. H. Ch. Stricker MB, PhD, J. W. G. Van Den Broek, J. Keuning, W. Eberhardt, H. G. J. Houben, M. Johnson & A. P. R. Blok

  8. Department of Pathology, Westeinde Hospital, The Hague, The Netherlands

    B. H. Ch. Stricker MB, PhD, J. W. G. Van Den Broek, J. Keuning, W. Eberhardt, H. G. J. Houben, M. Johnson & A. P. R. Blok

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  1. B. H. Ch. Stricker MB, PhD
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  2. J. W. G. Van Den Broek
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  3. J. Keuning
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  4. W. Eberhardt
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  5. H. G. J. Houben
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  6. M. Johnson
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  7. A. P. R. Blok
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Stricker, B.H.C., Van Den Broek, J.W.G., Keuning, J. et al. Cholestatic hepatitis due to antibacterial combination of amoxicillin and clavulanic acid (Augmentin). Digest Dis Sci 34, 1576–1580 (1989). https://doi.org/10.1007/BF01537113

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  • DOI: https://doi.org/10.1007/BF01537113

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