Background/Goals: There are limited data regarding the frequency and proporti onality of drug- induced hepatotoxicity in the United States. We sought to dete rmine the scope of nonfulminant drug- induced hepatitis as ...Background/Goals: There are limited data regarding the frequency and proporti onality of drug- induced hepatotoxicity in the United States. We sought to dete rmine the scope of nonfulminant drug- induced hepatitis as seen in a community - based hepatology referral service. Study: From a population of 4,039 outpatie nts referred for evaluation of acute (n = 96) and chronic (n = 3,943) liver dise ase over a 10- year period, we reviewed the records of those patients diagnosed with acute bona fide drug- induced hepatitis. Results: Thirty- two patients p resented with self- limited acute drug- induced hepatitis, representing 0.8% of all hepatology patients and 33% of those patients presenting with acute li ver injury. Antibiotics (amoxicillin/clavulanic acid, minocycline, nitrofurantoi n, an investigational ketolide antibiotic, trimethoprim- sulfamethoxazole, and trovafloxacin) were the class of drugs most frequently implicated (14 of 32; 44 % ), while amiodarone was the single agent most commonly associated with liver injury (7 of 32; 22% ). The mean age of affected patients was 52.2 years, and w e found a male predominance (18 of 32; 56% ). The mean time to biochemical reso lution after discontinuation of the offending agent was 14.1 weeks. Conclusions: Drug- induced hepatitis is an uncommon entity in clinical hepatology but does represent a significant proportion of acute self- limited liver disease in the United States. Antibiotics and amiodarone were the most common drug culprits in our population. Time to resolution following the discontinuation of the offendin g agent may be protracted. Prospective studies are needed to further assess the burden of drug- induced liver injury.展开更多
文摘Background/Goals: There are limited data regarding the frequency and proporti onality of drug- induced hepatotoxicity in the United States. We sought to dete rmine the scope of nonfulminant drug- induced hepatitis as seen in a community - based hepatology referral service. Study: From a population of 4,039 outpatie nts referred for evaluation of acute (n = 96) and chronic (n = 3,943) liver dise ase over a 10- year period, we reviewed the records of those patients diagnosed with acute bona fide drug- induced hepatitis. Results: Thirty- two patients p resented with self- limited acute drug- induced hepatitis, representing 0.8% of all hepatology patients and 33% of those patients presenting with acute li ver injury. Antibiotics (amoxicillin/clavulanic acid, minocycline, nitrofurantoi n, an investigational ketolide antibiotic, trimethoprim- sulfamethoxazole, and trovafloxacin) were the class of drugs most frequently implicated (14 of 32; 44 % ), while amiodarone was the single agent most commonly associated with liver injury (7 of 32; 22% ). The mean age of affected patients was 52.2 years, and w e found a male predominance (18 of 32; 56% ). The mean time to biochemical reso lution after discontinuation of the offending agent was 14.1 weeks. Conclusions: Drug- induced hepatitis is an uncommon entity in clinical hepatology but does represent a significant proportion of acute self- limited liver disease in the United States. Antibiotics and amiodarone were the most common drug culprits in our population. Time to resolution following the discontinuation of the offendin g agent may be protracted. Prospective studies are needed to further assess the burden of drug- induced liver injury.
