title: Probable sulbactam/ampicillin-associated prolonged cholestasis.
abstract: OBJECTIVE
  To present a single case of sulbactam/ampicillin-induced chronic cholestasis and a literature review of antibiotic-associated chronic cholestasis.
  
  
  METHODS
  A 74-year-old man with Hodgkin's disease in remission developed severe and prolonged cholestasis after treatment with sulbactam/ampicillin 750 mg twice daily for 7 days. All other etiologies, including Hodgkin's disease, were appropriately ruled out and the cholestasis was ascribed to sulbactam/ampicillin treatment. The patient improved gradually and became asymptomatic 7 months after the last dose of sulbactam/ampicillin. According to the Naranjo probability scale, sulbactam/ampicillin was the probable cause of the cholestasis.
  
  
  CONCLUSIONS
  Ampicillin, a semisynthetic penicillin, has rarely been associated with hepatic injury when used alone. Hepatocellular and acute cholestatic injury due to ampicillin have been described. Cholestasis secondary to sulbactam/ampicillin use has not been previously reported.
  
  
  CONCLUSIONS
  Sulbactam/ampicillin, one of the most widely used antibiotics, may cause chronic cholestatic hepatitis. Clinicians should be aware of this adverse affect and consider it during diagnostic workup of liver injury.
authors.affiliation: Department of Gastroenterology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey. gskoklu@yahoo.com
authors.forename: Seyfettin
authors.initials: S
authors.lastname: Köklü
authors.forename: Aydin S
authors.initials: AS
authors.lastname: Köksal
authors.forename: Mehmet
authors.initials: M
authors.lastname: Asil
authors.forename: Halil
authors.initials: H
authors.lastname: Kiyici
authors.forename: Sahin
authors.initials: S
authors.lastname: Coban
authors.forename: Mehmet
authors.initials: M
authors.lastname: Arhan
mesh_terms: D000368:Aged; D000667:Ampicillin / Q000008:administration & dosage / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002779:Cholestasis / Q000139:chemically induced*; D002908:Chronic Disease; D004338:Drug Combinations; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D013407:Sulbactam / Q000008:administration & dosage / Q000009:adverse effects*; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D004791:Enzyme Inhibitors; D000667:Ampicillin; D013407:Sulbactam