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Ma J, Björnsson ES, Chalasani N. Hepatotoxicity of Antibiotics and Antifungals and Their Safe Use in Hepatic Impairment. Semin Liver Dis 2024; 44:239-257. [PMID: 38740371 DOI: 10.1055/s-0044-1787062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Idiosyncratic drug-induced liver injury (DILI) is a rare and unpredictable form of hepatotoxicity. While its clinical course is usually benign, cases leading to liver transplantation or death can occur. Based on modern prospective registries, antimicrobials including antibiotics and antifungals are frequently implicated as common causes. Amoxicillin-clavulanate ranks as the most common cause for DILI in the Western World. Although the absolute risk of hepatotoxicity of these agents is low, as their usage is quite high, it is not uncommon for practitioners to encounter liver injury following the initiation of antibiotic or antifungal therapy. In this review article, mechanisms of hepatoxicity are presented. The adverse hepatic effects of well-established antibiotic and antifungal agents are described, including their frequency, severity, and pattern of injury and their HLA risks. We also review the drug labeling and prescription guidance from regulatory bodies, with a focus on individuals with hepatic impairment.
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Affiliation(s)
- J Ma
- Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana
| | - E S Björnsson
- Department of Gastroenterology, Landspitali University Hospital Reykjavik, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - N Chalasani
- Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana
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Wang Y, Yu G, Shi J, Zhang X, Huo J, Li M, Chen J, Yu L, Li Y, Han Z, Zhang J, Ren X, Wang Y, Yuntana W. Retrospective study about clinical severity and epidemiological analysis of the COVID-19 Omicron subvariant lineage-infected patients in Hohhot, China. BMC Infect Dis 2024; 24:206. [PMID: 38360539 PMCID: PMC10870667 DOI: 10.1186/s12879-024-09084-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/01/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Fear of a global public health issue and fresh infection wave in the persistent COVID-19 pandemic has been enflamed by the appearance of the novel variant Omicron BF.7 lineage. Recently, it has been seeing the novel Omicron subtype BF.7 lineage has sprawled exponentially in Hohhot. More than anything, risk stratification is significant to ascertain patients infected with COVID-19 who the most need in-hospital or in-home management. The study intends to understand the clinical severity and epidemiological characteristics of COVID-19 Omicron subvariant BF.7. lineage via gathering and analyzing the cases with Omicron subvariant in Hohhot, Inner Mongolia. METHODS Based upon this, we linked variant Omicron BF.7 individual-level information including sex, age, symptom, underlying conditions and vaccination record. Further, we divided the cases into various groups and assessed the severity of patients according to the symptoms of patients with COVID-19. Clinical indicators and data might help to predict disadvantage outcomes and progression among Omicron BF.7 patients. RESULTS In this study, in patients with severe symptoms, some indicators from real world data such as white blood cells, AST, ALT and CRE in patients with Omicron BF.7 in severe symptoms were significantly higher than mild and asymptomatic patients, while some indicators were significantly lower. CONCLUSIONS Above results suggested that the indicators were associated with ponderance of clinical symptoms. Our survey emphasized the value of timely investigations of clinical data obtained by systemic study to acquire detailed information.
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Affiliation(s)
- Yanhai Wang
- Clinical Laboratory Department, Hohhot First Hospital, Hohhot, 010000, China
| | - Guohui Yu
- Hohhot Dian Medical Laboratory, Key Laboratory of Digital Technology in Medical Diagnostics of Zhejiang Province, Dian Diagnostics Group Co., Ltd. No, 329 Jin Peng Street, Xihu District, Hangzhou, Zhejiang Province, 310030, China
| | - Jingru Shi
- Clinical Laboratory Department, Hohhot First Hospital, Hohhot, 010000, China
| | - Xiaqing Zhang
- Clinical Laboratory Department, Hohhot First Hospital, Hohhot, 010000, China
| | - Jianxin Huo
- Clinical Laboratory Department, Hohhot First Hospital, Hohhot, 010000, China
| | - Meng Li
- Clinical Laboratory Department, Hohhot First Hospital, Hohhot, 010000, China
| | - Jiaxi Chen
- Clinical Laboratory Department, Hohhot First Hospital, Hohhot, 010000, China
| | - Liyuan Yu
- Clinical Laboratory Department, Hohhot First Hospital, Hohhot, 010000, China
| | - Yan Li
- Clinical Laboratory Department, Hohhot First Hospital, Hohhot, 010000, China
| | - Zhiliang Han
- Clinical Laboratory Department, Hohhot First Hospital, Hohhot, 010000, China
| | - Jianwen Zhang
- Clinical Laboratory Department, Hohhot First Hospital, Hohhot, 010000, China
| | - Xuna Ren
- Clinical Laboratory Department, Hohhot First Hospital, Hohhot, 010000, China
| | - Yujie Wang
- Clinical Laboratory Department, Hohhot First Hospital, Hohhot, 010000, China
| | - Wu Yuntana
- Clinical Laboratory Department, Hohhot First Hospital, Hohhot, 010000, China.
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