Liver damage from flucloxacillin, cloxacillin and dicloxacillin.
We describe a case of severe cholestatic liver disease, which persisted for 7 years, and was probably induced by flucloxacillin. We also report a survey of 77 liver reactions which were probably or possibly induced by penicillinase-resistant penicillins and spontaneously reported to the Swedish Adverse Drug Reactions Advisory Committee. The reactions were usually cholestatic with a tendency to a protracted course. There is some evidence for an immunoallergic idiosyncratic reaction. The incidence of reported liver reactions was estimated from sales data to be 1.6-2.9 per million DDD (defined daily doses) or, for flucloxacillin 1:11,000-1:30,000 prescriptions. Female sex, age and high daily doses seemed to be associated with higher risk of liver reactions from flucloxacillin.
Olsson
R
R
Department of Medicine II, University of Gothenburg, Sweden.
Wiholm
B E
BE
Sand
C
C
Zettergren
L
L
Hultcrantz
R
R
Myrhed
M
M
D056486:Chemical and Drug Induced Liver Injury; D002779:Cholestasis / Q000139:chemically induced / Q000453:epidemiology / Q000473:pathology; D003023:Cloxacillin / Q000009:adverse effects*; D004009:Dicloxacillin / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005436:Floxacillin / Q000009:adverse effects*; D006801:Humans; D008099:Liver / Q000187:drug effects* / Q000473:pathology; D008875:Middle Aged; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors
D005436:Floxacillin; D004009:Dicloxacillin; D003023:Cloxacillin