Amoxicillin/clavulanate is a synthetic penicillin that is currently commonly used,especially for the treatment of respiratory and cutaneous infections.In general,it is a well-tolerated oral antibiotic.However,amoxicil...Amoxicillin/clavulanate is a synthetic penicillin that is currently commonly used,especially for the treatment of respiratory and cutaneous infections.In general,it is a well-tolerated oral antibiotic.However,amoxicillin/clavulanate can cause adverse effects,mainly cutaneous,gastrointestinal,hepatic and hematologic,in some cases.Presented here is a case report of a 63-yearold male patient who developed cholestatic hepatitis after recent use of amoxicillin/clavulanate.After 6 wk of prolonged use of the drug,he began to show signs of cholestatic icterus and developed severe hyperbilirubinemia(total bilirubin>300 mg/L).Diagnostic investigation was conducted by ultrasonography of the upper abdomen,serum tests for infection history,laboratory screening of autoimmune diseases,nuclear magnetic resonance(NMR)of the abdomen with bile duct-NMR and transcutaneous liver biopsy guided by ultrasound.The duration of disease was approximately 4 mo,with complete resolution of symptoms and laboratory changes at the end of that time period.Specific treatment was not instituted,only a combination of anti-emetic(metoclopramide)and cholestyramine for pruritus.展开更多
文摘Amoxicillin/clavulanate is a synthetic penicillin that is currently commonly used,especially for the treatment of respiratory and cutaneous infections.In general,it is a well-tolerated oral antibiotic.However,amoxicillin/clavulanate can cause adverse effects,mainly cutaneous,gastrointestinal,hepatic and hematologic,in some cases.Presented here is a case report of a 63-yearold male patient who developed cholestatic hepatitis after recent use of amoxicillin/clavulanate.After 6 wk of prolonged use of the drug,he began to show signs of cholestatic icterus and developed severe hyperbilirubinemia(total bilirubin>300 mg/L).Diagnostic investigation was conducted by ultrasonography of the upper abdomen,serum tests for infection history,laboratory screening of autoimmune diseases,nuclear magnetic resonance(NMR)of the abdomen with bile duct-NMR and transcutaneous liver biopsy guided by ultrasound.The duration of disease was approximately 4 mo,with complete resolution of symptoms and laboratory changes at the end of that time period.Specific treatment was not instituted,only a combination of anti-emetic(metoclopramide)and cholestyramine for pruritus.