A case of refractory cholestatic drug-induced liver injury caused by amoxicillin/clavulanate effectively treated with phenobarbital

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  • アモキシシリン/クラブラン酸による難治性胆汁うっ滞型薬物性肝障害に対しフェノバルビタールが有効であった一例
  • アモキシシリン/クラブランサン ニ ヨル ナンチセイ タンジュウウッタイガタ ヤクブツセイ カン ショウガイ ニ タイシ フェノバルビタール ガ ユウコウ デ アッタ イチレイ

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<p>A man in his 70s administered amoxicillin/clavulanate (AMPC/CVA) for 6 weeks for lung abscess treatment presented at our hospital with jaundice one week after treatment completion. Based on the DDW-J 2004 diagnostic criteria for drug-induced liver injury (DILI), the patient scored 6 points, raising suspicion of liver damage caused by AMPC/CVA. His jaundice worsened after initiation either of conservative therapy or PSL 30 mg and UDCA 300 mg after 1st liver biopsy. Although corticosteroid pulse therapy or taurine had no effect following 2nd liver biopsy, phenobarbital (PB) 120 mg/day exhibited outstanding effectiveness in reducing jaundice. We monitored the normal total bilirubin range after PB discontinuation. This case seems to be uncommon because of the characteristic course of cholestatic DILI due to AMPC/CVA and the remarkable effect of PB for refractory jaundice.</p>

Journal

  • Kanzo

    Kanzo 65 (9), 433-439, 2024-09-01

    The Japan Society of Hepatology

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