Recurrent Cholestasis Due to Ampicillin

Author:

Köklü Seyfettin1,Yüksel Osman2,Filik Levent3,Üsküdar Oğuz4,Altundağ Kadri5,Altiparmak Emin6

Affiliation:

1. Seyfettin Köklü MD, Research Fellow, Department of Gastroenterology, Türkiye Yüksek ihtisas Hospital, Ankara, Turkey

2. Osman Yüksel MD, Research Fellow, Department of Gastroenterology, Türkiye Yüksek ihtisas Hospital

3. Levent Filik MD, Research Fellow, Department of Gastroenterology Türkiye Yüksek ihtisas Hospital

4. Oğuz Üsküdar MD, Research Fellow, Department of Gastroenterology, Türkiye Yüksek ihtisas Hospital

5. Kadri Altundağ MD, Associate Professor, Department of Medical Oncology, Hacettepe University Institute of Oncology, Ankara

6. Emin Altiparmak MD, Instructor, Department of Gastroenterology, Türkiye Yüksek ihtisas Hospital

Abstract

OBJECTIVE: To present a single case of ampicillin-induced recurrent cholestasis and a literature review. CASE SUMMARY: A 23-year-old man was hospitalized due to recurrent and self-limited cholestatic symptoms. He had used ampicillin before each cholestatic attack. He became well clinically and biochemically each time after cessation of the drug. One year after his recovery and discontinuance of ampicillin, the patient has had no recurrence of cholestasis. An objective causality assessment revealed that the adverse drug reaction was probable. DISCUSSION: Ampicillin-related hepatotoxicity is very rare, with injury being mainly hepatocellular. To our knowledge, there is only 1 case report in the literature referring to chronic cholestatic-type hepatotoxicity related to ampicillin. CONCLUSIONS: Ampicillin, which is one of the most widely used antibiotics, may cause recurrent cholestatic hepatitis. Clinicians should be aware of this adverse effect, and it should be kept in mind during diagnostic workup of liver injury.

Publisher

SAGE Publications

Subject

Pharmacology (medical)

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1. Antibiotic residues in food animals: Public health concern;Acta Ecologica Sinica;2019-10

2. Drug-Induced Liver Injury;Zakim and Boyer's Hepatology;2018

3. Antibiotic induced liver injury: what about children?;Journal of Chemotherapy;2013-10

4. Hepatotoxicity of Antimicrobials and Antifungal Agents;Drug-Induced Liver Disease;2013

5. Adverse reactions to β-lactam antimicrobials;Expert Opinion on Drug Safety;2012-01-06

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