American Journal of Otolaryngology
Volume 28, Issue 1 , January 2007, Pages 28-30

Original contribution

Amoxicillin-clavulanic acid–induced hepatitis

Jason Cundiff MD, a, and Stephanie Joe MDa,

aDepartment of Otalaryngology-Head and Neck Surgery, University of Illinois,
Chicago, IL, USA

Received 17 March 2006. Available online 9 December 2006.




Abstract
Objectives
The aim of this study was to report a rare side effect of
amoxicillin-clavulanic acid resulting in drug-induced hepatitis in the
treatment of chronic rhinosinusitis.

Methods
This is a case report and literature review of amoxicillin-clavulanic
acid–induced hepatitis in the treatment of chronic rhinosinusitis. A MEDLINE
search of the published literature from 1966 to 2006 was performed using the
term “amoxicillin-clavulanic acid + hepatitis.”

Results
We report a case of a 53-year-old man who developed drug-induced hepatitis
after the use of amoxicillin-clavulanic acid for the treatment of chronic
rhinosinusitis. After a 4-week course of amoxicillin-clavulanic acid, the
patient developed pruritus and jaundice. Liver function tests revealed
elevated aminotransferase levels. Serologic examination result for hepatitis
A, B, and C was negative. The amoxicillin-clavulanic acid was discontinued
and the patient was treated conservatively. The pruritus and jaundice
gradually resolved and the patient had no long-term complications. The
literature review revealed this is the first reported case of
amoxicillin-clavulanic acid–induced hepatitis for the treatment of chronic
rhinosinusitis.

Conclusions
Drug-induced hepatitis is a rare side effect of amoxicillin-clavulanic acid.
Care must be taken in prescribing this drug to elderly patients and patients
with liver disease. In general, the hepatitis is mild to moderate, rarely
leads to liver failure, and can be managed conservatively.

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