阿莫西林致肝损害个案汇总分析

Amoxicillin-induced hepatotoxicity:review of medical literatures

目的:调查阿莫西林致肝损害的发生情况及其临床特点。方法:收集1979-2009年国内外医学文献中阿莫西林所致肝损害的病例报告,对阿莫西林致肝损害的患者年龄、用药情况、给药剂量、不良反应发生时间和特点及转归等进行分析。结果:共有24篇个案报道文献纳入统计,涉及阿莫西林所致肝损害患者为25例,男性15例,女性10例,平均年龄为59岁。其中应用阿莫西林5例,阿莫西林/克拉维酸20例。不良反应可发生在用药期间,也可发生于停药数周后,发生时间中位数为开始给药后19d,治愈时间中位数为6周。死亡4例。结论:阿莫西林、阿莫西林/克拉维酸均可致肝损害,老年人发生率高。临床使用中应注意其肝损害的发生。

Objective：To investigate the amoxicillin-induced liver disorder and its clinical characteristics.Methods：The case reports of amoxicillin-induced liver disorder were collected from medical literatures in domestic and abroad between 1979 and 2009.The data were analyzed in respect of the distribution of patients age,the dosage and administration of amoxicillin,onset time and clinical characteristics of adverse reactions,consequence and prognosis.Results：A total of 24 case reports were collected.Twenty-five patients of amoxicillin-induced liver disorder were reported with 15 men and 10 women,and average age of 59.Among these cases,5 patients received amoxicillin and 20 patients were given amoxicillin/clavulanic acid.The adverse reactions happened during the treatment course or several weeks after the treatment.The median time of occurrence was 19 days after administration,and the median time of recovery was 6 weeks.Four patients died.Conclusion：Amoxicillin and amoxicillin/clavulanic acid can cause hepatotoxicity,while the elderly patients were high risk population.It should be paid more attention to the hepatotoxicity induced by amoxicillin in order to promote the rational drug use.