Antibiotics: Single largest class of drugs causing liver injury

Dec 01, 2008

Antibiotics are the single largest class of agents that cause idiosyncratic drug-induced liver injury (DILI), reports a new study in Gastroenterology, an official journal of the American Gastroenterological Association (AGA) Institute. DILI is the most common cause of death from acute liver failure and accounts for approximately 13 percent of cases of acute liver failure in the U.S. It is caused by a wide variety of prescription and nonprescription medications, nutritional supplements and herbals.

"DILI is a serious health problem that impacts patients, physicians, government regulators and the pharmaceutical industry," said Naga P. Chalasani, MD, of the Indiana University School of Medicine and lead author of the study. "Further efforts are needed in defining its pathogenesis and developing means for the early detection, accurate diagnosis, prevention and treatment of DILI."

In this prospective, ongoing, multi-center observational study — the largest of its kind — patients with suspected DILI were enrolled based upon predefined criteria and followed for at least six months. Those with acetaminophen liver injury were excluded.

Researchers found that DILI was caused by a single prescription medication in 73 percent of the cases, by dietary supplements in 9 percent and by multiple agents in 18 percent. More than 100 different agents were associated with DILI; antimicrobials (45.5 percent) and central nervous system agents (15 percent) were the most common. Of the dietary supplements causing DILI, compounds that claim to promote weight loss and muscle building accounted for nearly 60 percent of the cases. The study found that at least 20 percent of patients with DILI ingest more than one potentially hepatotoxic agent.

DILI remains a diagnosis of exclusion and thus detailed testing should be performed to exclude competing causes of liver disease; importantly, acute hepatitis C virus (HCV) infection should be carefully excluded in patients with suspected DILI by HCV RNA testing. Researchers found no relationship between gender and severity of DILI, but individuals with diabetes experienced more severe DILI.

Source: American Gastroenterological Association

Explore further: FDA approves second vaccine against meningitis strain

add to favorites email to friend print save as pdf

Related Stories

NASA spacecraft almost to Pluto: Smile for the camera!

1 hour ago

NASA's New Horizons spacecraft is nearing the end of its nine-year voyage to Pluto, with just over 100 million miles (160 million kilometers) to go before reaching there this July. In the meantime—starting ...

Recommended for you

Medical charity warns India over patent rules

Jan 21, 2015

Doctors without Borders on Wednesday warned the Indian government not to bow to US pressure to amend patent regulations that allow millions access to affordable medicines, ahead of a visit by President Barack Obama.

Why are some generic drugs getting so expensive?

Jan 21, 2015

More than eight out of every 10 prescriptions dispensed in the US is generic. This growth is due to a large number of top-selling drugs going off patent over the past decade, as well as innovations in t ...

Supreme Court sides with Teva in drug dispute

Jan 20, 2015

The Supreme Court on Tuesday sided with Teva Pharmaceutical Industries Ltd. in the company's high-profile patent dispute with rival firms over the top-selling multiple sclerosis drug.

User comments : 1

Adjust slider to filter visible comments by rank

Display comments: newest first

SDMike
not rated yet Dec 01, 2008
"caused by a wide variety of prescription and nonprescription medications, nutritional supplements and herbals."

And they are????

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.