NDLI: Acute hepatitis associated with the use of levofloxacin.

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Acute hepatitis associated with the use of levofloxacin.

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Acute hepatitis associated with the use of levofloxacin.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Figueira-Coelho, João Pereira, Olga Picado, Bárbara Mendonça, Paula Neves-Costa, José Neta, Jorge
Description	Country affiliation: Portugal Author Affiliation: Figueira-Coelho J ( Department of Medicine I, Hospital Curry Cabrai, Lisbon, Portugal. jffcoelho@gmail.com)
Abstract	BACKGROUND: Levofloxacin is a fluoroquinolone used globally to treat respiratory, skin, and genitourinary tract infections. It is generally well tolerated and there is a very low risk for liver injury in patients taking this antibiotic. OBJECTIVE: We report an acute case of hepatitis following treatment with levofloxacin for pneumonia. CASE SUMMARY: A 77-year-old white male (height, 162 cm; weight, 58 kg) with chronic bronchitis presented to the emergency department of the Hospital Curry Cabral, Lisbon, Portugal, with respiratory difficulty and productive cough. The patient had a history of chronic bronchitis, arterial hypertension, hypercholesterolemia, and benign prostatic hyperplasia, and was being treated with salmeterol 50 µg plus fluticasone 250 µg BID, and amlodipine 5 mg, simvastatin 20 mg, alfuzosin 10 mg, and finasteride 5 mg once daily. Initially, the patient refused admission and was sent home, medicated with levofloxacin 500 mg once daily (single dose) for pneumonia and acetaminophen 1 g (as needed, maximum TID) if axillary temperature exceeded 38.0°C (100.4°F). Three days later, the patient returned for a follow-up visit, and despite clinical and radiologic improvement, blood tests revealed a slight aggravation of anemia. On the seventh day of treatment with levofloxacin, the patient showed an elevation of transaminases. The temporal relation between the use of levofloxacin and the liver injury, the exclusion of other causes of hepatitis, and a compatible liver biopsy (conducted 14 days after identification of hepatitis) was consistent with the diagnosis of levofloxacin-associated hepatotoxicity. Levofloxacin treatment was stopped and the patient made a full recovery. The Naranjo Adverse Drug Reaction Probability Scale score for this association was 'probable' (score 7) and the Roussel Uclaf Causality Assessment Method Scale score was 'highly probable' (score 9). Unlike the 5 reported cases in the literature, this is the only case in which both a liver biopsy was performed in the course of the disease and the patient survived. CONCLUSION: The acute hepatitis observed in this elderly patient was probably associated with the administration of levofloxacin.
File Format	HTM / HTML
ISSN	01492918
Issue Number	10
Volume Number	32
e-ISSN	1879114X
Journal	Clinical Therapeutics
Language	English
Publisher	Elsevier
Publisher Date	2010-09-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Pharmacology Anti-bacterial Agents Adverse Effects Drug-induced Liver Injury Etiology Levofloxacin Ofloxacin Acute Disease Aged Administration & Dosage Therapeutic Use Biopsy, Needle Diagnosis Pathology Humans Liver Function Tests Male Pneumonia Drug Therapy Treatment Outcome Case Reports Journal Article
Content Type	Text
Resource Type	Case study Article
Subject	Pharmacology Pharmacology (medical)

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