title: [Antibiotic induced hepatotoxicity].
abstract: Drug-induced liver injury (DILI) is the most common cause of drug withdrawal of the market though it remains quite seldom. Actually, its incidence reaches about 1/100000 prescriptions. Antibiotics are the most implicated substances: 3 clinical cases are presented. The clinical manifestations are broad, appear between 5 to 90 days after the introduction of the drug and range from an asymptomatic patient to an acute hepatic failure. This diagnosis is difficult to establish. After excluding a biliary obstruction and a septic cholangitis at first, many additional investigations can be performed, but induce considerable costs. Drug history is the key element of the diagnostic approach. An algorithm is presented at the end of this article to prevent expensive, invasive and useless investigations.
authors.affiliation: Service de médecine interne, HFR Fribourg, Hôpital cantonal, 1708 Fribourg. rhynerg@h-fr.ch
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Rhyner
authors.forename: Kourosh
authors.initials: K
authors.lastname: Zahedi
authors.forename: Philippe
authors.initials: P
authors.lastname: Stadler
authors.forename: Daniel
authors.initials: D
authors.lastname: Hayoz
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000633:toxicity*; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology; D002779:Cholestasis / Q000139:chemically induced / Q000175:diagnosis; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged
chemical_list: D000900:Anti-Bacterial Agents