Summary
A 75-year-old man developed a biopsy-proven, drug-induced intrahepatic cholestasis after use of amoxycillin trihydrate combined with the Β-lactam inhibitor potassium clavulanate (Augmentin). Cholestatic liver injury is an uncommonly recognized, probably immunologically based adverse reaction to therapy with penicillin and its derivatives.
Similar content being viewed by others
References
Zimmerman HJ, Maddrey WC: Toxic and drug-induced Hepatitis.In Diseases of the Liver. L Schiff, ER Schiff (eds). Lippincott, Philadelphia, 1981, pp 621–692
Biour M, Poupon R, Calmus Y, et al: Hepatotocicite des Medicamantes—fichier bibliographaique des attientes hepatiques et des medicamantes responsables. Gastroenterol Clin Biol 11:56–67, 1987
Williams CN, Malatjalian DA: Severe penicillin-induced cholestasis in a 91-year-old female. Dig Dis Sci 26(5):470–474, 1981
Victorino Rui MM, Maria Vaco A, Correia A Pinto, de Moura C: Floxacillin-induced cholestatic hepatitis with evidence of lymphocyte sensitization. Arch Intern Med 147(5): 987–989, 1987
Deboever G: Cholestatic jaundice due to derivatives of oxacillin. Am J Gastroenterol 82(5):483, 1987
Konikoff F, Alcalay J, Halevy J: Cloxacillin-induced cholestatic jaundice. Am J Gastroenterol 81(11):1082–1083, 1986
Bengsston F, Floren CH, Hagerstrand I, Sodestrom C, Aberg T: Flucloxacillin-induced cholestatic liver damage. Scand J Infect Dis 17:125–128, 1985
Enat R, Pollack S, Ben-arieh Y, Livni E, Barzilai D: Cholestatic jaundice caused by cloxacillin—macrophage inhibition factor test in preventing rechallenge with hepatotoxic drugs. Br Med J 280:982–983, 1980
Aderka D, Livni E, Salmon F, Weingerger A, Pinkhas J. Use of macrophage inhibition factor and mast cell degranulation tests for diagnosis of cloxacillin-induced cholestasis. Am J Gastroenterol 81(11):1084–1086, 1986
Mandell GL, Sande MA: Antimicrobial Agents—Penicillins, Cephalosporins, and other Β-lactam antibiotics. Goodman and Gillman, New York, Macmillan, 1985, Chapter 50, pp 1115–1147
Abraham EP, Chain EB: An enzyme from bacteria able to destroy penicillin. Nature 146:837, 1940
Parker RH, Eggleston M: Beta-lactamase inhibitors—another approach to overcoming antimicrobial resistance. Infect Control 8(1):36–40, 1987
Conner CS: Β-Lactamase inhibitors. Drug Intell Clin Pharm 19(6):475–476, 1985
Amoxycillin-clavulanic acid. Med Lett Drugs Ther 9:99–100, 1984
Waugh D: Myocarditis, arteritis, focal hepatic, splenic and renal granulomas apparently due to penicillin sensitivity. Am J Pathol 28:437–447, 1952
Kishida H, Kisaka Y, Matsubayashi S, et al: Clinical evaluation of clavulanic acid-amoxycillin in the fields of obstetrics and gynaecology. Jpn J Antibiot 36(3):487–499, 1983
Karachalions GN: Treatment of respiratory tract infections with a combination of amoxycillin and clavulancic acid. Int J Clin Pharmacol Ther Toxicol 23(12):647–649, 1985
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Dowsett, J.F., Gillow, T., Heagerty, A. et al. Amoxycillin/clavulanic acid (augmentin)-induced intrahepatic cholestasis. Digest Dis Sci 34, 1290–1293 (1989). https://doi.org/10.1007/BF01537281
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01537281